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ABSN Cohort 19 > MedSurge Exam2 > Flashcards

MedSurge Exam2 Flashcards

(61 cards)

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1
Q

Reference Ranges

Na, K, Ca, Mg, P, Cl

A 
135 - 145
3.5 - 5
9 - 10.5
1 - 2
3.0 - 4.5
98 - 106
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2
Q

Reference Ranges

BUN, Creatinine, Blood, Urine Specific Gravity

A

10 - 20
0.5 - 1.5
70 - 120
1.00 - 1.03

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3
Q

Reference Ranges

WBC, RBC, Hgb, Hct

A

4k - 10k
4.6 - 5.5
13.5 - 15.5
39 - 49

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4
Q

Reference Ranges

T3, T4, HDL, LDL, ADH

A 
70 - 205
4 - 12
> 50
< 190
1 - 5
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5
Q

Cushings @ Plasma Cortisol

A

suggestive if Ø↑ in mornings and ↓ night

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6
Q

Salivary Cortisol and hypercorticoidism

A

suggestive if ↑<2.0 @ midnight

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7
Q

Urinary Cortisol and hypercorticoidism

A

sugg. if ↑10-100

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8
Q

Reference Range

Serum ACTH and direction Addisons/Cushings

A

25 - 200
↑ Addisons
↓ Cushings

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9
Q

VMA test Range and direction

A

↑2-7 sugg. pheochromocytoma

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10
Q

Fx on SIADH on Urine [Na, K, Cl, Osma]

A 
75 - 200
26 - 123
110 - 250
200 - 800
Low values is sugg.
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11
Q

Pain med re-assessment interval

A

30 - 60 minutes

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12
Q

Acute vs Chronic Pain

A

Temporary FoF S/S
vs
Ongoing >60mo ØFof byt depression, fatigue

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13
Q

Nonopiods

A

Mild - Moderate

Acetaminophen (toxic if >4 days), NSAIDS, salicylates (tinnitus, vertigo. ↓hearing)

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14
Q

Opiods

A

Moderate - Severe
Morphine, Fentanyl (Sublimaze)
(constipation, hypoTN, UTR, Resp Depression)

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15
Q

Phantom Pain? Feeling/meds

A

pins and needles/anti-depressants/spasmodics

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16
Q

Adjuvants

A

Boost nonopiods

Anti/convulsant (Tegretol), anxiety (Valium, Depressants (Elavil)

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17
Q

4 CAMS

A

Natural Products - supplements
Mind-body - imagery, meditation
Manipulative - chiropractice
Other - touch, reiki

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18
Q

6 Herbs

A

Ginkgo Biloba - memory/bleeding
Garlic - Chol and BP - bleeding
Glucosamine - inflammation, ØWarfarin
Ginseng - anti-aging, ØWarfarin
Saw Palmetto - prostatic hyperplasia, Øclotting
Aromatherapy - well-being, nausea and vomitting

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19
Q

Pain Perceptions 4

A

Addiction - compulsive use despite harm
Psuedoadditcion - anger w/ staff b/c undertx
Tolerance - rq. ↑ drug for fx
Physical Dependence - withdrawal

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20
Q

WHO Pain Relief Ladder

A
  1. Nonopiod (g/t adjuvant)
  2. Weak opiod (g/t nonopiod/adjuvant)
  3. Strong opiod (g/t nonopiod/adjuvant)
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21
Q

Benzodiazepines

A

reduce anxiety pre-surgery
Diazepam (Valium and Versed)
Adfx. CR

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22
Q

Antiemetics

A

Decrease post-anesthetic nausea/vomitting
Ondansetron (Zofran)
Adfx. Dry mouth, dizziness

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23
Q

Sedatives

A

General anesthesia
Pentobarbital (Nembutal)
Adfx Øgive if w/in 14 days MAOI

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24
Q

Neuromuscular Blocking Agents

A

Skeletal relaxation/Airway placement
Succinylcholine (Anectine)
Rq. mechanical ventilation b/c blocks all contraction

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25
Phases of General. Anesthesia
Induction Maintenance Emergence
26
Malignant Hyperthermia Overdose Anesthetic Unrecognized Hyperventilation Intubation Problems
Hot contractions, iced NSS and Dantrolene (Dantrium) Proper screening Monitor equipment Proper assistance, r/in sore throat/neck injury
27
Epidural/Spinal blockade Interventions (3)
lower head quiet environment keep hydrated
28
Types of Surgeries (4)
Emergency Palliative Elective Radical
29
Renal Failure | Fx on BUN/Creatinine
↑
30
Type of assessment for BUN, Creatinine, Na, Ca, catecholamines, and proteins
24 hour
31
Renal GRAM interventions have...? | 4 followups
Iodine, so check seafood allergies, meds, history of asthma, and get an enema
32
Hemodialysis Dos(5) and Don'ts(3)
Elevate, x3week, 3-5 hour sessions, 2 needles, continue held meds afterwards Take BP, give IV, injection near access site.
33
Hemodialysis vs. Peritodialysis
Running lines through veins, filling peritoneal cavity with hypertonic glucose solution to even out electrolytes. B/c loss, gain... watch labs.
34
Acute (4 phases) vs. Chronic Glomulonephritis (5 stages)
Acute - clogged, recovers Chronic - progressive destruction AKI - onset, oliguria, diuresis, recovery CKD - 1 (90), 2 (60), 3 (30), 4 (15), 5 (<15)
35
Reasons for pre, intra, post renal injury
pre - fluid leveles intra - injury post - obstruction
36
S/S UTR
Protein, blood, etc. in urine Low labs, High WBC/leukocyte esterase/nitrates Lethargy, deep sighing, yawning, anemia, ↓turgor
37
Renal Calculi Fx, tx, and 4 food groups to avoid
``` ↑ Ca absorption ↓ excretion Treat w/ opiods q4h Calcium phosphate - high animal protein Calicum Oxalate - spinach and K stuff Struvite - dairy, red mean, whole grain P stuff Uric Acid - Poultry, fish, wine ```
38
ADH fx if too high/low
``` high = SIADH, retaining low = polyuria, sugg. DI ```
39
Water Deprivaiton Test
Don't drink H2O | If [urine] ↑ then +
40
VMA Testing
24 hour collection Vanillymandelic acid w/out K foods
41
Clonidine Suppression Test
Catecholamines q3h before Clonidine (Catapres) | if BP Ø↓ +
42
Fx SIADH
↑ urine specific gravity | ↓ all labs b/c retention
43
Phentolamine Blocking test
Phentolamine (Regitene) Ablocker administered | if BP ↑= 25, pheochromocytoma
44
Cushings Syndrome
Hyperfx Adrenal Cortex r/in ↑ cortisol
45
Dexamethasone Suppression TEst
Dexa PO. ATCH and Cortisone should drop. | No? + Cushings
46
Fx DI
Sunken eyes, Tachy, HypoTN | ↓ urine labs ↑ serum labs, osmo, and thirst
47
Fx SIASH
↑ urine labs, ↑ serum labs | RESTRICT FLUIDS TO .5 - 1 L/day
48
Cushings Fx on Labs
↑ Na | ↓ K, Ca, Glucose
49
Addisons Syndrome
Adrenal Insufficiency | ↓ aldosterone and cortisol
50
Addisons Fx on labs
↓ Na | ↑ K, Ca, Glucose
51
Hyperthyroidism Fx and Tx (3)
``` Overdrive! Reduce stimulation Thionamides (Methimazole and PTU 1-2 years) Propanolol (Inderal) to relieve S/S Iodine Solutions - after meds ```
52
Hypothyroidism Fx and Tx
``` Cooldown! Levothyroxin (Synthoid) Replacement therapy q2-3wks !!! fiber, calcium, iron, antacides. TAKE ON EMPTY STOMACH ```
53
Diabetes S/S (4)
``` Hyperglycemia Polyuria Polydipsia Polyphagia Acetone/Fruity Breath ```
54
Diabetes Expected Labs (4)
Casual > 200 Fasting > 126 2 hour > 200 w/ oral tolerance Urinanalysis (glucose/ketones in urine)
55
Type1 v Type 2 Diabetes
1 - genetic, younger, Ø beta cells | 2 - behavioral, older, resistance,
56
Kussmaul Respirations
b/c acid buildup to substitute energy production. | ↑ rate and depth of respirations and fruity breath
57
Glycogenesis Glycogenolysis Ketogenesis Gluconeogenesis
glucose to glycogen glycogen to glucose fat to acid protein to glucose
58
Diabetic KetoAcidosis vs. Hyperglycemia-hyperosmolar state
DK- ↑ ketosis b/c ↓ insulin PH < 7.4 | HHS- ↓ insulin, hydration. PH > 7.4
59
Fx Hypoglycemia vs. Hyperglycemia
Cool clammy, anxious, Øresp change | Warm moist, stuporous, Kussmaul Resps.
60
Mild, Moderate, Severe hypoglycemia and tx
hungry, irritable, eat sweet things cold, clammy, rapid pulse, rapid absorbing carbs dysphagia, unconscious - IM/SubQ glucagon
61
Diabetes 2 drug alerts
Metformin r/in lactic acidosis Actos, anti-diabetic. NOT Actonel, which prevents calcium loss.

ABSN Cohort 19 (28 decks)

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