Medical Surgical - Week 3 Tips Flashcards by Joshua De Jesus

♥ Sounds (All People Enjoy The Movies)

Aortic - 2nd R intercostal
Pulmonic - 2nd L intercostal
Erb's - 3rd L intercostal
Tricuspid - 4th L intercostal
Mitral/Apex - 5th L intercostal

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Stroke Signs (FAST)

Face
Arms
Speech
Time

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Compartment Syndrome S/S (5Ps)

Pain
Pallor
Pulse declined/absent
Pressure ↑
Paresthesia

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Shock S/S (CHORD ITEM)

Cold, clammy skin
Hypotension
Oliguria
Rapid, shallow breathing
Drowsiness, confusion
Irritability
Tachycardia
Elevated/↓ Central Venous Pressure
Multi-Organ Damage

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Hypoglycemia S/S (TIRED)

Tachycardia
Irritability
Restlessness
Excessive Hunger
Depression/Diaphoresis

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Hypocalcemia S/S (CATS)

Convulsions
Arrhythmias
Tetany
Stridor/Spasms

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Hypokalemia S/S (6Ls)

Lethargy
Leg cramps
Limp muscles
Low, shallow respirations
Lethal cardiac dysrhythmias
Lots of urine (Polyuria)

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Traction Patient Care (TRACTION)

Temperature of extremity
Rope hang freely
Alignment of body
Circulation check
Type/Location fracture
Increase fluid intake
Overhead trapeze
No weights on bed/floor

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Cancer Early Warning Signs (CAUTION UP)

▲ bowel/bladder
A non-healing lesion
Unusual bleeding
Thickening of lump
Indigestion/dysphagia
Obvious ▲ to wart/mole
Nagging cough
Unexplained weight loss
Pernicious anemia

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Leukemia S/S (ANT)

Anemia/↓Hgb
Neutropenia/↓WBC
Thrombocytopenia/↑r/o bleeding

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TIA

Transient Ischemic Attack (mini-stroke)

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Pernicious Anemia

anemia r/t inability to absorb Vitamin B12

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Uremia and S/S (3)

anemia r/t kidney failure

seizures, purpura, lethargy

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Purpura

rash of purple spots r/t internal bleeding

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Asthma Management (ASTHMA)

Adrenergics (Albuterol and bronchodilators)
Steroids
Theophylline
Hydration IV
Mask O2 therapy
Antibiotics if +infx

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Hypoxia (early RAT, late BED)

Restlessness
Anxiety
Tachycardia/pnea

Bradycardia
Extreme restlessness
Dyspnea

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Pneumothorax S/S (P-THORAX)

Pleuretic pain
Trachea deviation
Hyperresonance
Onset sudden
Reduced breath sounds/dyspnea
Absent fremitis
X-ray shows collapsed lung

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Constipation counters (3)

Exercise
High fiber
Fluid intake

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Dysphagia causes (COIE)

Certain neuro disorders
Obstruction
Inflammation
Edema

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Dysphagia counters (THOA)

Thick/textured foods
High Fowlers
Oral Care
Adequate time

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Dumping Syndrome and (4) S/S

inability of pyloric sphincter to control movement of food into small intestine as r/o gastric surgeries

N/V, distention, cramping, diarrhea 15 minute post-eating

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Dumping counters (5)

Small frequent meals
Fluids 1 hr AFTER meals
fat/protein
Ø concentrated sugar
Ø lactose

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What is GERD?

indigestion and heartburn from backflow of acidic juices onto the mucosa of the lower esophagus

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GERD Education (4)

Encourage weight loss (if overweight)
Avoid large meals/bedtime snacks
Avoid citrusy, spicy, and carbonated beverages
Avoid foods that reduce lower esophageal sphincter (LES) pressure

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Things that lower LES pressure (6)

``` Alcohol Caffeine Chocolate Fatty foods Pepper/Spearmint Cigarettes ```

Peptic Ulcer Disease (PUD) is characterized by...?

erosion of mucosal layer of stomach or duodenum

Causes of PUD (2)?

``` Bacterial infection (H. Pylori) Chronic NSAID use (aspirin/ibuprofen) ```

PUD Education (2)

AVOID frequent meals/snacks | Avoid Bad things, NSAIDS, black pepper, spicy foods

Lactose Intolerance is caused by...?

inadequate lactase enzyme that digests lactose

S/S Lactose Intolerance (4)

distention, cramps, flatus, diarrhea

Lactose Intolerance Education

Avoid anything with lactose in it (including chocolate and puddings)

Diverticulosis/itis is...?

pouch(es) in the colon caused by a low-fiber diet which ↑ abdominal pressure

Diverticulosis/itis prevention*

High fiber diet UNLESS ACUTE, keep low to reduce bowel stimulation

Diverticulosis/itis Education

Avoid seeds/husks

Cholecystitis is...?

inflammation of the gallbladder

Cholecystitis counter

Reduction of fat intake

Cholecystitis aggravators (3)

Things with lots of pieces, coffee, and seasoned foods

Acute Renal Failure (ARF) is...?

a sudden decline in renal function

Acute Renal Failure (ARF) causes (4)

trauma sepsis poor perfusion medications

Acute Renal Failure (ARF) complications (4)

HYPOnatremia HYPERkalemia HYPOcalcemia HYPERphosphatemia

ARF counter

Diet Therapy

Pre-End stage Renal Disease (pre-ERD) is...?

diminished renal reserve with ↑ in serum CK (predialysis condition)

Goals of nutrition therapy for pre-ESRD (3)

preserve renal function control glucose levels control HTN

pre-ESRB and protein

restrict to slow progression of disease, but not completely. Proteins needed for health.

pre-ESRB and phosphorus

restrict to slow progression of disease. High levels r/in calcium and phosphorus deposits in the kidneys.

End Stage Renal Disease (ESRD) is...?

Chronic renal failure when GFR is ↓ 24 mL/min and CK steadily rises DIALYSIS/TRANSPLANT REQUIRED!!!

ESRD Diet (5)

``` HIGH protein LOW phosphorus LOW potassium LOW sodium Fluid restrictions ```

ESRD caution with 2 labs?

Calcium and VitD

Why HIGH protein with ESRD?

Alot of it (and amino acids) is lost in dialysis

ESRD 50% protein consumption source?

Biologic sources

ESRD calorie consumption ratio? Why?

35 cal/kg body weight to maintain protein stores

ESRD and phosphorus

RESTRICT, put Phosphate Binders with all meals/snacks

ESRD and VitD

Deficiency occurs b/c kidneys can't convert it to active form

ESRD and Calcium

Deficiency because is often found in foods w/ K, which are restricted

ESRD and sodium/fluids

allowed depending on BP, weight, serum electrolytes, and urine output

Nephrolithiasis (Kidney Stones)

Renal calculi in kidneys due to excessive intake of protein, sodium, calcium, and oxalates

Oxalates? (3)

rhubarb spinach beets

Kidney Stone prevention?

↑ fluid intake

Orders of Prioritization (4)

1. Tx immediate threats (ABCs) 2. Tx actual problem (N/V, full bladder) 3. Monitor for complications/education 4. Tx potential problems

Maslow's Hierarchy of Needs (5)

1. Physiological 2. Safety 3. Social 4. Esteem 5. Self-Actualization

Erikson's Stages of Development (8)

1. Infant 0 - 1 year - Trust vs. Mistrust 2. Toddler 1 - 3 years - Autonomy vs. Shame 3. Preschooler 3 - 5 years - Initiative vs Guilt 4. School Age 6 - 12 years - Industry vs. Inferiority 5. Adolescent 12 - 18 years - Identity vs. Role Confusion 6. Young Adult 18 - 35 - Intimacy vs. Isolation 7. Middle-aged Adult 35 - 65 - Generativity vs. Stagnation 8. Late Adult 65+ - Integrity vs. Despair

Medical Surgical - Week 3 Tips Flashcards

(61 cards)