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Flashcards in Med Surg Deck (74)
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0
Q

Exercise for osteoarthritis

A

Exercise consistently weather pain is present or not.

1
Q

1st step when blood is ready from bank

A

Confirm the type and match

2
Q

Fall off ladder with l/arm fx

A
Head to toe
Cut away clothing
Remove jewelry
Assess neurological status
Splint arm
3
Q

Tensions pneumothorax

A

Chest asymetry
Air enters during inspiration and does not exit during expiration.
Tracheal deviation to the unaffected side.

4
Q

Flail chest

A

Paradoxic chest movement

Movement of the thorax out on expiration and inward inspiration

5
Q

Lactulose

A

Stimulates the production of excess stools to rid the body of ammonia. Excessive stools cause hypokalemia and dehydration

6
Q

Priority assessment for a spinal cord injury with a Halo fixation device

A

The greatest risk is to neurological damage. Peripheral reflexes and sensation should be assessed and a decrease should be reported to the provider

7
Q

Priority assessment for IV potassium therapy.

A

The client is admitted with dehydration and a potassium level of 2.8. The highest priority would be a urine output below 20 mL per hour for two hours because potassium is excreted in the kidneys and this could result in accumulation of potassium and development of life-threatening dysrhythmias

Swelling at the insertion site can indicate infiltration or leakage and should be reported immediately

8
Q

Myxedema coma and hypothyroidism

A

Slow speech would indicate a risk for myxedema coma coma because hypothyroidism results in reduced perfusion to the brain

9
Q

Hypothyroidism

A

Constipation due to decrease G.I. motility.
Cold intolerance due to decreased metabolic rate.
Decreased body temperature due to decreased metabolic rate
Hypotension
Weight gain
Bradycardia

10
Q

Clinical manifestations of type two diabetes mellitus

A

Polyurea, polydipsia, neuropathy

11
Q

Priority finding after a TURP

A

Red colored urine with occasional clots

Bladder spasms are common, and pain level of six is common and a low-grade temperature is common

12
Q

Erythropoietin

A

Iron supplements may be needed. It will help decrease fatigue and improve activity tolerance. Hemoglobin should be closely monitored while on this medication.

It does not impact the need for a protein restriction

13
Q

Complication of mechanical ventilation

A

Stress ulcers are caused by elevated levels of hydrochloric acid in the stomach

May cause hypotension, fluid retention, and hyponatremia

14
Q

Laboratory value with hypoactive bowel sounds

A

Hypokalemia decreases G.I. motility and can cause abdominal distention

On a sidenote, hyponatremia increases G.I. motility and hyperactive bowel sounds

15
Q

Bee sting

A
Inject epinephrine
Remove the Stinger
Clean with soap and water
Apply ice
Seek medical help
16
Q

Tensilon test

A

After administration of Tensilon, the client demonstrates increased muscle weakness and twitching. This indicates a cholinergic crisis.

In a myasthenic crisis, muscle weakness would improve after administration of tensilon

17
Q

Digoxin toxicity

A

Visual disturbances

Impaired renal function increases the risk of toxicity

18
Q

Signs of increased intracranial pressure

A

Sleepiness, widening pulse pressure, decerebrate posturing, distended jugular veins,

Papilledema, Cushing’s Triad, slurred speech, decorticate posturing

19
Q

Biliary colic

A

Anticholinergic a will decrease spasms of the bile ducts.

20
Q

Peritoneal dialysis

A

If constipated and anorexia an enema should be given prior to dialysis

21
Q

TB

A

Sputum specimens are necessary every 2 to 4 weeks until there are three negative cultures.

The client is no longer contagious after TB medications have been taken for 2 to 3 weeks

22
Q

Mannitol/osmitrol

A

Headache is adverse affect and needs reported immediately

23
Q

Thyroid storm

A

Systolic blood pressure elevated

Propranolol is given to reduce effects of thyroid hormone on the heart.

24
Q

Malignant hyperthermia

A

The heart rate greater than 120. Hypotension. Tachypnea. Muscle rigidity

25
Q

Propranolol hydrochloride/inderal

A

Beta blocker

Adverse reaction is bronchoconstriction

26
Q

Dumping syndrome

A

Prevent it: Lie down after meals, consume high protein, hi fat, low carb diet. Limit fluids during meals and 1 hour after

27
Q

Cardioversion

A

Hold digoxin prior to it

Stay on lovenox

28
Q

Thoracentesis

A

Encourage the client take deep breaths after the procedure. The client will be sitting and leaning over an over bed table or lying supine with arms raised.

29
Q

Hyperkalemia

A

Peaked T waves, wide QRS
causes acute renal failure
Give kayexalate to reduce K

30
Q

Metformin

A

Decreases the amount of glucose produced in the liver. It does not increase secretion of insulin. It should be taken with food Especially with the evening meal to slow the release of medication at night.

31
Q

Hyperthyroidism

A

Insomnia, tachycardia, diaphoresis

Tremors, wide eyed, restlessness, irritable, heat intolerance.

32
Q

Advantage of a PICC

A

It can be inserted in the upper extremity compared to the torso where there are more organisms

33
Q

Carvedilol (coreg)

A

Expected effects include fatigue, diarrhea, and orthostatic hypotension. Report weight gain because this can worsen heart failure.

34
Q

Right hemispheric CVA

A

Visual spatial deficits, left hemianopsia, one sided neglect

Impulsive behavior

35
Q

Left hemispheric CVA

A

Expressive aphasia, right hemiplegia, inability to read.

36
Q

Gastric hemorrhage going into shock

A

Give o2
IV fluids
NG tube
Zantac

37
Q

Heatstroke

A

Anxiety, loss of muscle coordination, skin that is hot and dry. Place the client on a cooling blanket

38
Q

Meyoclopramide reglan

A

Dopamine agonist

Extra pyramidal symptoms such as involuntary facial movements is an adverse effect.

39
Q

Hep B

A

Arthralgia

40
Q

Ileostomy

A

Reddish purple color indicates ischemia

Wt gain is expected,

41
Q

Hep c

A

Avoid all alcohol consumption
Avoid Tylenol
No special diet
Lots of meds may need decreased dose

42
Q

Acute pancreatitis

A

Priority is pain management.

May also need NG tube, antibiotic, and hyperglycemia monitoring.

43
Q

Bacterial gastroenteritis

A

Avoid Lomotil because it decreases GI motility. Fluid replacement and ciprofloxacin should be used

44
Q

Test for Addison’s disease

A

ACTH. Adrenocorticotropic hormone stimulation test

45
Q

Propylthiouracil

A

Suppresses thyroid hormone and allows for wt gain

Decreases sweating, decreases bowel movement, reduces appetite

46
Q

Alcohol and diabetes

A

Two fat exchanges are substituted for every beverage containing alcohol. Ingest alcohol with meals to reduce hypoglycemia. Alcohol increases triglyceride levels. Insulin may need to be decreased due to the hypoglycemic effect of alcohol

47
Q

DKA

A

Blood glucose levels above 300. Kussmaul deep respirations. Weight loss. Increased urine output

48
Q

Long-term effects of corticosteroids

A

Osteoporosis, development of a moon shaped face, increased risk of infection, muscle wasting of extremities

49
Q

Adrenal insufficiency

A

Elevated calcium level. Decreased sodium level. Weight loss. Increased potassium

Give hydrocortisone succinate to replace cortisol deficiency.
Encourage fluids

50
Q

Cushings disease

A

Elevated blood glucose, decreased calcium, decrease potassium, decreased lymphocytes

Hirsutism.
Elevated BP
Wt gain
Thinning of skin

51
Q

Hypocalcemia

A

Tingling and numbness of the hands and feet, hyperactive deep tendon reflexes, increased G.I. motility, weak thready pulse.

52
Q

Venus versus arterial ulcer

A

If the client is experiencing claudication it indicates an arterial ulcer.

53
Q

ACE inhibitors

A

Discontinue if they have a persistent cough.

Frequent urination is expected outcome

54
Q

Anesthesia and drug interactions

A

Captopril, an anti hypertensive agent may cause hypotensive crisis.

55
Q

Hyperacute kidney rejection

A

Organ will need to be removed

56
Q

Clindamycin

A

Watery diarrhea could cause pseudomembranous colitis. Report immediately and discontinue the medication

57
Q

AIDSvs HIV

A

The presence of small purple colored skin lesions indicating Kaposi’s sarcoma, signifies that the client has developed AIDS. The CD4 count with AIDS is below 200.

58
Q

SLE. Lupus

A

Raynaud’s Phenomenon occurs in they should use gloves when it’s cold outside. You should use a sunscreen with SPF of 30. It cannot be cured. It can affect all systems in the body and cause pleural effusions and pneumonia

Decreased urine output due to kidney damage. Pleural effusion and dyspnea. Joint inflammation

59
Q

Amoxicillin

A

Take with food. The capsules can be opened or crushed.

60
Q

Pulmonary embolism

A

Give heparin 1300 units per hour IV

61
Q

ABG

A
Hold pressure for 5 minutes
Aspirate into heparinized syringe
Do not insert air
Transport immediately
Perform Allen's test to make sure there is sufficient blood flow.
62
Q

Oxygen flow

A
B
Nasal cannula 2-6 L, o2 28-44%
Nonrebreather. >90%fio2, highest level
Face mask 40-60%
Partial rebreather 60-75%
63
Q

Emphysema

A

Report cyanotic lips

Fatigue, barrel shaped chest, and crackles in the posterior chest are expected

64
Q

Albuterol

A

For acute asthma attacks

Side effect is tachycardia
Does not cause candidiasis. That is betamethasome.

65
Q

Gentamicin

A

Causes nephrotoxicity

Aminoglycoside

66
Q

Dopamine

A

Given to olguria renal failure to enhance blood flow to the kidneys and increase BP.

67
Q

Acute renal failure

A
Increased BUN
decreased urine output
Elevated K
Decreased Ca
Decreased hct
68
Q

Chronic renal failure

A
Diet low in protein
Limit phosphorus
Take calcium and vitamin d
Low sodium
Weigh daily

If BUN 126, high K, high sodium, give insulin and D10W. LASIK does not help if kidney failure.

69
Q

Acute glomerular nephritis

A

Dark urine
Fluid retention, high BP, Na retention
Decreased urine output
Gains weight

70
Q

Potassium foods

A

NOT APPLES

Cantaloupe, raw spinach, potatoes

71
Q

Acute pyelonephritis

A

Give IV antibiotics.
2-3 L water
Balanced diet

72
Q

Retinal detachment

A

Flashes of bright light or floating dark spots.

Painless

73
Q

Carbidopa/levodopa Sinemet

A
Parkinson's
Orthostatic hypotension 
Not with high protein foods
Saliva. Urine, sweat darkens in color
Weeks to months to work.