Flashcards in Med Surge Deck (239)
What is Addison's disease and what are the s/s?
Hyposecretion of adrenal hormones (mineralcorticoids, glucocorticoids - cortisol, and androgens - aldosterone) Occurs in all age groups and affects both sexes. Can be life-threatening. Treatment involves taking hormones to replace the insufficient amounts.
S/S: fatigue, weakness, dehydration, low BP, hyperpigmentation, low resistance to stress, alopecia, weight loss, pathological fractures, depression, lethargy, emotional lability. Patho: low na+ & dehydration, low blood volume / shock, high K+/metabolic acidosis/ arrythmias, low blood sugar and insulin shock
what are the precipitating factors of an addisonian crisis?
physical or emotional stress, sudden withdrawal of hormones
What are the s/s of an addisonian crisis?
n/v, abdominal pain, fever, extreme weakness, severe hypoglycemia, hyperkalemia, and dehydration. bp falls leading to shock/coma/death.
How do you treat an addisonian crisis?
Carefully monitor IV infusion of 0.9% NaCl or DSW/ NaCl
Administer IV glucose, glucagon
Administer insulin with dextrose in normal saline
administer potassium-binding and excreting resin (e.g., sodium polystyrene sulfonate) Monitor vital signs
what is Reynaud's disease?
excessively reduced blood flow in response to cold or emotional stress, causing discolouration of the fingers, toes, and occasionally other areas. This condition may also cause nails to become brittle with longitudinal ridges. Treatment involves encouraging circulation and avoiding vasoconstriction.
what is impetigo, s/s?
highly contagious bacterial skin infection most common among pre-school children. s/s : skin lesions/rash with honey-colored scabs. It is primarily caused by Staphylococcus. if intreated may cause glomerulrlonephritis. treat with antibiotics.
What are the s/s of toxic shock syndrome?
What is the diet for a patient with Meniere's disease? why?
low-sodium diet to prevent fluid retention (specifically the endo-lymphatic fluid found in the laybrinth of the inner ear.
What is Meniere's disease?
A disorder of the inner ear that causes spontaneous episodes of vertigo (a sensation of a spinning motion), fluctuating hearing loss, ringing in the ear (tinnitus), and sometimes a feeling of fullness or pressure in your ear. In many cases, Meniere's disease affects only one ear. Chronic. Episodes usually last 20min-2H, but may last 24 h. severe N/V may occur. Vertigo is uncommon and could be a sign of stroke, brain tumor, multipul sclerosis or cardiovasc. disease.
Diet for cystic fibrosis.
High protein, high calorie b/c of impaired intestinal absorbtion. salty foods recommended due to excess sodium loss during sweating.
What foods help manage smells from a colostomy? other methods?
cranberry juice, buttermilk, parsley, and yogurt help prevent odors. crackers, toast and yogurts help prevent gas. may also use a commercial deodorant. avoid skipping meals, chewing gum, drinking beer, and smoking.
RX for ectopic pregnancy.
Abortion - if allowed to grow may kill mother because of hemorrhage. Methotrexate or surgery.
correct positioning after lumbar puncture
flat supine; to prevent headache by preventing leakage of CSF at site.
diet for dumping syndrome.
increase fat and protein. decrease carbs because they are the first to be digested (want to slow digestion), decrease fiber.
avoid drinking fluids with meals (none 1h before or 2h after), 5-6 small meals per day, lie down after eating.
what is the cerebrum and what are the 4 lobes?
The cerebrum controls emotions, hearing, vision, personality all voluntary actions and more. The 4 lobes are frontal, temporal, occipital, parietal
what is the the location and function of the temporal lobe?
Responsible for processing auditory information from the ears (hearing)
what is the the location and function of the frontal lobe?
Carries out higher mental processes such as thinking, decision making, and planning,where our personality is formed
what is the the location and function of the occipital lobe?
Responsible for processing visual information from the eyes
what is the the location and function of the parietal lobe?
Processes sensory information that had to do with taste, temperature, and touch
what are the functions of the left hemisphere of the brain?
Responsible for control of the right side of the body, and is the more academic and logical side of the brain: analytic thought, logic, language, reasoning, science, math, written, number skills, right hand control, speech
what are the functions of the right hemisphere of the brain?
Responsible for control of the left side of the body, and is the more artistic and creative side of the brain: art awareness, creativity, imagination, intuition, insight, holistic thought, music awareness, 3d forms, left hand control, spacial awareness
Symptoms of right hemisphere damage
issues with attention, perception, reasoning and problem solving, memory, social communication, organization, insight, orientation, may be unaware of his or her impairment and be certain that he or she can perform the same tasks as before, unmotivated, spatial-perceptual difficulties. (these individuals may be seen as uncooperative, confused, overly dependent or unmotivated.) , impulsive, disoriented to person place and time.
Symptoms of left hemisphere damage
personality changes, communication problems and some paralysis on the right side,behave in a cautious, compulsive, or disorganized way and are easily frustrated, may be slow to take action or to respond to questions, impaired speech
normal urine output
The normal range for 24-hour urine volume is 800 to 2000ml per day (33-83ml per hour) (with a normal fluid intake of about 2 liters per day). if output is below 30ml/h further eval is needed.
what is the effect of increased carbon dioxide on intracranial pressure? what are the potential implications for patients? (Nursing Care)
CO2 causes dilation of cerebral blood vessels. Ensuring adequate ABC's is priority for patients with head injuries or increased ICP.
Name the 12 cranial nerves, their functions, and how to assess their functionality
oh oh oh tiny tits are fun and give virgins awkward hips:
I: Olfactory - smell - ASK IF THEY CAN SMELL
II: Optic - vision - VISUAL ACUITY TEST
III: Oculomotor - motor control of some eye muscles and eyelid - PERRLA (pupils equal round reactive to light and accommodation), GAZE UP, DOWN, OUT
IV: Trochlear - motor control of some eye muscles - GAZE DOWN AND IN
V: Trigeminal (dentist) - chewing - FACIAL SENSORY
VI: Abducens - motor control of some eye muscles - GAZE TEMPORARILY
VII: Facial - motor control of facial muscles, salivation, taste and cutanious sensations - FACIAL EXPRESSIONS
VIII: Vestibulococholear (auditory) - equilibrium, hearing - HEARING TEST
IX: Glossopharyengeal - salivation, sensations of skin taste and viscera - GAG REFLEX
X: Vagus - motor control of heart and viscera, sensation from thorax , pharynx, and abdominal viscera. - CHECK THE UVULA IS MIDLINE
XI: Accessory (spinal) - motor impulse to pharynx and shoulder - SHOULDER SHRUG
XII: Hypoglossal - motor control of tongue, some skeletal muscles, and some viscera , sensation from skin and viscera - TOUNGE MOVEMENT
What is Autonomic dysreflexia and what are the symptoms? What are a few nursing actions
Autonomic dysreflexia (AD), also known as autonomic hyperreflexia, is a potentially life-threatening condition which can be considered a medical emergency requiring immediate attention. AD occurs most often in spinal cord-injured individuals. Acute AD is a reaction of the autonomic (involuntary) nervous system to overstimulation. It is characterized by paroxysmal hypertension (the sudden onset of severe high blood pressure) associated with throbbing headaches, profuse sweating, nasal stuffiness, flushing of the skin above the level of the lesion, slow heart rate, anxiety, and sometimes by cognitive impairment.
Nursing actions: high fowlers, potentially admin hydralazine (vasodilator)
priority nursing actions for a woman in labor showing late decelerations on the fhr monitor.
position on left side, 02, IV, notify hcp
what is the timeline for alcohol withdrawal?
withdrawal : 5-35 hours after last drink, 48 hours grand mal seizures, 72-96 hours delirium tremens - at high risk for seizures.