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Flashcards in Med Surg Final Review Deck (45):
1

CD4 Count

800-1400
Anything <200, you have AIDS
<800, immunosuppressed

Interventions for Aids
- blood spills should be cleaned with 1:10 bleach

2

Sickle Cell Anemia

2 triggers: dehydration and hypoxia
Hypoxia: painful in varied tissues

3

Causes of leukemia

- radiation
- Immature WBC
- Infection
- Low platelets
- Decreased RBC

4

Anemia

- pale
- SOB
- Pica

Pernicious anemia- intrinsic factor for B12 insufficient, seen in bypass patients and elderly

Iron deficiency anemia- could be due to hemorrhage or low iron

5

DIC

decrease in clotting factor
Give heparin, clotting factors, and plasma because it has clotting factors in it

6

If patient is in kidney failure what lab should we check?

Creatinine

7

Test that differentiates Hodgkins from non-hodgkins

Reed Sternberg

8

Bone Marrow Transplant

Give chemo first to kill off everything, wait 2-3 days, give stem cells IV. If patient rejects stem cells, will get peeling in hands and feet

9

Chemotherapy

Costic- give through central line- can be oral, intrathecal, or IV- if IV, dilute!!!! Lots of water!!!- most important lab to watch is platelets

10

Radiation

SE: fatigue, pathological fractures later on

11

Parkinsons

Starts as a tremor, moves to shuffle, then the face.
RISK FOR: falls and aspiration

SE to dopamine: involuntary movement, anxiety, psychological SE such as dementia, allergy

12

Allergic reactions

Happen within 20-30 minutes of exposure. Give Epi: 1.3-1.5mL of 1/1,000

13

Lupus

Can impact all systems so we can't predict what it will effect in each patient.
Mostly seen in females
Diagnostic test: First ANA, then Anti-Smith test

Treatment: Goal: prevent further deterioration of the organ attacked. Give Aspirin, NSAIDs, anti-rheumatic medications

14

Guillian Bare

Diagnostic test: EMG and spinal tap

15

Myasthenia graves

Often see ptosis

Diagnose: give tensilon- 20 minutes later they will be fine Can also put ice on the eyes

Treatment: Tensilon

16

Multiple Sclerosis

Treat with IV steroids

3 things to check when giving steroids:
- immunocompromised
- taper down
- blood glucose

17

Plasmaphoresis

Can do for antibody disorders. Take blood, remove antibodies and return blood to body.

18

Seizures

Grand mal- following seizure: check for injury, turn on side and let sleep

Epilepsy: will be on dilantin forever, should never take Coumadin

19

COPD

High H&H, High RBCs
Check blood gasses and pulmonary function
O2- 2-4L/min max

Postural drainage is involved in chest physiotherapy
Smoking increases mucous
PC: pneumonia

20

Incentive spirometer used to prevent what?

Pneumonia

21

TB

Night sweats

Diagnostics: has to be sputum

If you have a positive ID test, need to have 3 consecutive sputum negatives and then you go home

22

OSHA

protective clothing, hobbies, smoking, dust

23

Systemic IV

At risk for overload or air embolus

24

Cytoxic vs. Anaphylactic allergic reaction

Blood transfusion- cytoxic
Anaphylactic- bee sting, food- can prevent death by wearing a medical bracelet.

25

Transfusions

Plasma/albumin/platelets- special, shorter tubing

26

Thyroid

If the thyroid is the problem, TSH is high because the thyroid is not putting T3 and T4

Graves disease- Hyperthyroidism, poppy eyes
Hypothyroidism- goiter, tired, always cold, weight gain

Goiter- can happen with either hyper or hypo

Thyroid storm- hyperthyroidism, high temp, drug of choice to treat is PTU and tapisol

27

Adrenal Gland

Addison's disease- hypo function. Give Salt and steroids. can be fatal without steroids (Addison's crisis), Need more steroids with stressed. If they take too much steroids, could end up with cushings

Cushings disease- hyper function.

28

parathyroid

Hypoparathyroidism--> hypocalcemia--> tetany--> notify provider and give Calcium gluconate

Hyperparathyroidism- at risk for kidney stones--> push fluids

29

DI and SIADH

Diabetes Insipidus- Low specific gravity, peeing a lot so more electrolytes left inside the body- SG will be: 1.001-1.005

SIADH: Will have a high specific gravity. Not peeing enough so electrolytes are diluted in the body.

30

Hypertension

Impacts cardiovascular and kidney the most. Should lose weight. Should be on a low fat, low sodium diet. Exercise: walking

Meds: ACE inhibitors, Lasix- depletes potassium so watch if also on digoxin

31

Nitroglycerine

Vasodilator used to relieve angina. Give 1 every 5 minutes X3. If no relief, call 911, probably an MI.

32

CAD

Caused by Increased fat in diet and low activity level. If the artery is totally plugged we can give a thrombolytic within the first 6 hours. If it is not totally plugged, we will give heparin and a stent.

Should be on a low fat diet to prevent CAD

33

CHF

First sign of right sided HF- edema
First sign of left sided HF- dyspnea because fluid is backing up into lungs.

PC: pulmonary edema, LISTEN TO THE LUNGS and look for frothy pink sputum (also important to look for this in PEs)

Probably on Lasix, look at potassium and report any weight gain.

34

Angina

Ischemia of the heart- sit them down and stop activity.

Stable angina- goes away with rest

Unstable angina- does not go away even with rest, can be a precursor to an MI

Ballooning and Stenting are good for both stable and unstable angina- also good for kidney carotids and PAD

35

MI

means infarction- pain is unrelieved

Treat with MONA- Morphine, oxygen, nitroglycerine, and ***chewable aspirin. Also give beta blockers.

EKG can show an MI while it's happening or it could not.

36

Acute Coronary Syndrome (ACS)

Any condition brought on by a sudden reduction or blockage of blood flow to the heart.

Algorithm- Nitro X3, O2, aspirin, beta blocker

ST elevation is very significant in diagnosing ACS

Need to sit down, rest, and take nitro. If no relief, could be unstable and lead to an MI.

37

Tissue Plaminogen Activator (TPA) (Thrombolytics)

Must be given within the first 6 hours of pain.

PC is a Pulmonary embolism (check for pink, frothy sputum), or stroke

38

Heparin

Prevents further damage but does not bust clots

Check aPTT levels

Give at same time as warfarin until warfarin levels are sufficient, then d/c heaprin

Antidote: Protamine sulfate
Antidote to warfarin- vitamin K

39

Infection of the heart

Named by location:
Pericarditis
Myocarditis
Endocarditis

At risk: IV drug users

Can lead to cardiomyopathies
Give antibiotics
Diagnose with echo

40

Aortic regurgitation

first sign: blood goes back into the lungs, difficulty breathing

41

Stenosis

A narrowing of the spinal canal
Often found in individuals with artificial valves
Need antibiotics

42

Arterial problems (Reynauds and bergers)

PC: deep and round ulcer

Experience pain at rest

43

Venous problems

PC- superficial and jagged edge ulcer- drainage

Pain with activity

44

PAD

Experience intermittent pain usually experienced in the legs

Can be arterial blockage, think about CAD

45

DVT

Leg care: don't move the leg until you know the clot is stable. Even then, a physician or specially trained nurse should move patient.