Exercise for osteoarthritis
Exercise consistently weather pain is present or not.
1st step when blood is ready from bank
Confirm the type and match
Fall off ladder with l/arm fx
Head to toe Cut away clothing Remove jewelry Assess neurological status Splint arm
Tensions pneumothorax
Chest asymetry
Air enters during inspiration and does not exit during expiration.
Tracheal deviation to the unaffected side.
Flail chest
Paradoxic chest movement
Movement of the thorax out on expiration and inward inspiration
Lactulose
Stimulates the production of excess stools to rid the body of ammonia. Excessive stools cause hypokalemia and dehydration
Priority assessment for a spinal cord injury with a Halo fixation device
The greatest risk is to neurological damage. Peripheral reflexes and sensation should be assessed and a decrease should be reported to the provider
Priority assessment for IV potassium therapy.
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
Myxedema coma and hypothyroidism
Slow speech would indicate a risk for myxedema coma coma because hypothyroidism results in reduced perfusion to the brain
Hypothyroidism
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
Clinical manifestations of type two diabetes mellitus
Polyurea, polydipsia, neuropathy
Priority finding after a TURP
Red colored urine with occasional clots
Bladder spasms are common, and pain level of six is common and a low-grade temperature is common
Erythropoietin
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
Complication of mechanical ventilation
Stress ulcers are caused by elevated levels of hydrochloric acid in the stomach
May cause hypotension, fluid retention, and hyponatremia
Laboratory value with hypoactive bowel sounds
Hypokalemia decreases G.I. motility and can cause abdominal distention
On a sidenote, hyponatremia increases G.I. motility and hyperactive bowel sounds
Bee sting
Inject epinephrine Remove the Stinger Clean with soap and water Apply ice Seek medical help
Tensilon test
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
Digoxin toxicity
Visual disturbances
Impaired renal function increases the risk of toxicity
Signs of increased intracranial pressure
Sleepiness, widening pulse pressure, decerebrate posturing, distended jugular veins,
Papilledema, Cushing’s Triad, slurred speech, decorticate posturing
Biliary colic
Anticholinergic a will decrease spasms of the bile ducts.
Peritoneal dialysis
If constipated and anorexia an enema should be given prior to dialysis
TB
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
Mannitol/osmitrol
Headache is adverse affect and needs reported immediately
Thyroid storm
Systolic blood pressure elevated
Propranolol is given to reduce effects of thyroid hormone on the heart.
Malignant hyperthermia
The heart rate greater than 120. Hypotension. Tachypnea. Muscle rigidity
Propranolol hydrochloride/inderal
Beta blocker
Adverse reaction is bronchoconstriction
Dumping syndrome
Prevent it: Lie down after meals, consume high protein, hi fat, low carb diet. Limit fluids during meals and 1 hour after
Cardioversion
Hold digoxin prior to it
Stay on lovenox
Thoracentesis
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.
Hyperkalemia
Peaked T waves, wide QRS
causes acute renal failure
Give kayexalate to reduce K
Metformin
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.
Hyperthyroidism
Insomnia, tachycardia, diaphoresis
Tremors, wide eyed, restlessness, irritable, heat intolerance.
Advantage of a PICC
It can be inserted in the upper extremity compared to the torso where there are more organisms
Carvedilol (coreg)
Expected effects include fatigue, diarrhea, and orthostatic hypotension. Report weight gain because this can worsen heart failure.
Right hemispheric CVA
Visual spatial deficits, left hemianopsia, one sided neglect
Impulsive behavior
Left hemispheric CVA
Expressive aphasia, right hemiplegia, inability to read.
Gastric hemorrhage going into shock
Give o2
IV fluids
NG tube
Zantac
Heatstroke
Anxiety, loss of muscle coordination, skin that is hot and dry. Place the client on a cooling blanket
Meyoclopramide reglan
Dopamine agonist
Extra pyramidal symptoms such as involuntary facial movements is an adverse effect.
Hep B
Arthralgia
Ileostomy
Reddish purple color indicates ischemia
Wt gain is expected,
Hep c
Avoid all alcohol consumption
Avoid Tylenol
No special diet
Lots of meds may need decreased dose
Acute pancreatitis
Priority is pain management.
May also need NG tube, antibiotic, and hyperglycemia monitoring.
Bacterial gastroenteritis
Avoid Lomotil because it decreases GI motility. Fluid replacement and ciprofloxacin should be used
Test for Addison’s disease
ACTH. Adrenocorticotropic hormone stimulation test
Propylthiouracil
Suppresses thyroid hormone and allows for wt gain
Decreases sweating, decreases bowel movement, reduces appetite
Alcohol and diabetes
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
DKA
Blood glucose levels above 300. Kussmaul deep respirations. Weight loss. Increased urine output
Long-term effects of corticosteroids
Osteoporosis, development of a moon shaped face, increased risk of infection, muscle wasting of extremities
Adrenal insufficiency
Elevated calcium level. Decreased sodium level. Weight loss. Increased potassium
Give hydrocortisone succinate to replace cortisol deficiency.
Encourage fluids
Cushings disease
Elevated blood glucose, decreased calcium, decrease potassium, decreased lymphocytes
Hirsutism.
Elevated BP
Wt gain
Thinning of skin
Hypocalcemia
Tingling and numbness of the hands and feet, hyperactive deep tendon reflexes, increased G.I. motility, weak thready pulse.
Venus versus arterial ulcer
If the client is experiencing claudication it indicates an arterial ulcer.
ACE inhibitors
Discontinue if they have a persistent cough.
Frequent urination is expected outcome
Anesthesia and drug interactions
Captopril, an anti hypertensive agent may cause hypotensive crisis.
Hyperacute kidney rejection
Organ will need to be removed
Clindamycin
Watery diarrhea could cause pseudomembranous colitis. Report immediately and discontinue the medication
AIDSvs HIV
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.
SLE. Lupus
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
Amoxicillin
Take with food. The capsules can be opened or crushed.
Pulmonary embolism
Give heparin 1300 units per hour IV
ABG
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.
Oxygen flow
B Nasal cannula 2-6 L, o2 28-44% Nonrebreather. >90%fio2, highest level Face mask 40-60% Partial rebreather 60-75%
Emphysema
Report cyanotic lips
Fatigue, barrel shaped chest, and crackles in the posterior chest are expected
Albuterol
For acute asthma attacks
Side effect is tachycardia
Does not cause candidiasis. That is betamethasome.
Gentamicin
Causes nephrotoxicity
Aminoglycoside
Dopamine
Given to olguria renal failure to enhance blood flow to the kidneys and increase BP.
Acute renal failure
Increased BUN decreased urine output Elevated K Decreased Ca Decreased hct
Chronic renal failure
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.
Acute glomerular nephritis
Dark urine
Fluid retention, high BP, Na retention
Decreased urine output
Gains weight
Potassium foods
NOT APPLES
Cantaloupe, raw spinach, potatoes
Acute pyelonephritis
Give IV antibiotics.
2-3 L water
Balanced diet
Retinal detachment
Flashes of bright light or floating dark spots.
Painless
Carbidopa/levodopa Sinemet
Parkinson's Orthostatic hypotension Not with high protein foods Saliva. Urine, sweat darkens in color Weeks to months to work.
