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ABSN Cohort 19 > MedSurgs2 Exam1 > Flashcards

MedSurgs2 Exam1 Flashcards

(49 cards)

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1
Q

Anaphylaxis: Type#, Onset time, Caused by

A

Type 1
Within seconds to minutes
Caused by exposure to specific allergen

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2
Q

Anaphylaxis FX (2)

A

widespread
↓ blood vessel tone
↓ cardiac output

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3
Q

Anaphylaxis Onset S/S Subj (5)

A 
Uneasiness
Apprehension
Weakness
Anxiety
Impending Doom
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4
Q

Anaphylaxis Onset S/S Skin (5)

A 
Generalized itching
Urticaria (hives)
Erythema
Angioedema (swelling of eyes), lips, and tongue
Itchy Skin
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5
Q

Anaphylaxis Onset S/S Respiratory (9)

A 
Bronchconstriction
Mucosal Edema
↑ Mucous production
Respiratory Distress
Wheezing, Crackles, Hoarseness, Stridor
"Lump in Throat"
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6
Q

Anaphylaxis Onset S/S Cardio (6)

A 
Hypoxemia
HypoTN
Rapid/Weak Irregular Pulse (also by vasodilation or ↑ capillary leak)
Faint
Diaphoretic
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7
Q

Anaph. # Criterias

A

3

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8
Q

Ana. Criteria 1

Onset and Fx (3x3)

A

Within mins - hrs
Swelling - Swollen lips, uvula, and hives
Respiratory distress - dyspnea, wheezes, low peak expiratory rate
HypoTN r/in ↓ perfusion r/in organ d/fx - r/in LoC, incontinence, hyptonia, absent reflexes

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9
Q

Ana. Criteria 2

Onset and Fx (1 + 1x3)

A

Within min - hrs of >2 of the following
Any Criteria 1
GI - N/V, cramping, ab. pain

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10
Q

Ana. Criteria 3

Onset and Fx (2)

A

Within mins - hrs of…

HTN with BPS

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11
Q

Education for Leukemic Pt on Infx Protection (8)

A 
Oral/Hand/Skin Care/Hygiene
Ø Crowds
Protective Equipment 
Flu/Pneumonia Vaccines
Recgonize S/S of Infx
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12
Q

Leukemia (What is it and the Fx?)

Acute or Chronic?

A

Cancer r/in uncontrolled production of “Blast” WBC.
r/in production of immature d/fxal cells and ↓ RBC output

Can be both Acute (sudden/short) and Chronic (slow/long).

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13
Q

Leuk. and WBC?

A

Even though pt might have normal WBC levels, they are immature and Ø fight off infx

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14
Q

Leuk. S/S Cardiovascular (↑ 2, ↓ 1)

A

↑ HR, RR

↓ BP

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15
Q

Leuk. S/S Respiratory (3)

A

Murmurs/Bruits

Ab.normal breath sounds

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16
Q

Leuk. S/S Subj. (5)

A 
Fatigue
Neurological Changes
Headache
Fever
Bone/Joint pain
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17
Q

Leuk. S/S Skin and GI (4)

A

Bleeding
Cool/Pallor Skin
Intestinal Changes

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18
Q

Transplants Throughout the Years (10)

A

Kidney focal point
1912 - transplanting blood vessels
1930 - skin grafting for burns common
end of 1940 - kidney transplant for 6 mo.
1954 - first renal transplants b2n twins
1960 - Imuran (Azathoproine) immunosuppression
↑ Renal transplant survival rates b/c other immunosuppressions.
Liver/Pancreas transplant
↓ Success rate for ♥ transplants 1968 - 1970
Cyclosporine developed

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19
Q 
Acute Rejection
Onset
Graft HLA recognized as...?
Type of response
Cells do what?
R/in?
A

days - months
HLA antigens are recognized as foreign (non-self)
Type 4 cell-mediated Hypersensitive Response
T Lymphocytes/Macrophages proliferate attach and destroy donor tissue
Cytotoxic antibodies, which further aggravates acute rejection process

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20
Q

AIDS pts should?

21
Q

Appropriate interventions with Thrombocytopenia pt (10)

Study These Flashcards
A 
Handle gently
Ø IM or Venipunctures
Pressure Needle stick in the same site for 10 minutes until Ø bleeding
Smallest needle necessary
Observe sites q2h for bleeding
Ice Traumas
Test Urine/Stool for blood

NO BUTT BREAKERS (enemas, lube, anal sex)
Measure abdominal girth

22
Q

PTT and INR Ranges and r/t anti-coagulant

Study These Flashcards
A

25 - 35 r/t Heparin

2.0 - 3.0 r/t Warfarin

23
Q

Sick Cell Anemia
What is it?
Fx?

Study These Flashcards
A

Genetic dz r/in anemia, pain, early death caused by pair of HbS alelles
40% total hemogloblin have abnormal HbS, r/in ↓ O2… they also chain together and clump.

24
Q

Thrombocytopenia important educations (+5)

Study These Flashcards
A 
SEE Interventions +
Electric shavers
Avoid mouth trauma
Ø blow nose/insert objects
Ø contact sports
firm shoe soles
25
``` Blood Transfusion Pre-Procedure 3 steps 3 notes 3 steps 2 notes 2 steps ```
``` CHIPPI Assess values (Packs RBCs for ```
26
Blood Transf. Intra-Procedure 3, 6 RNC24 VDM+1CD
Remain w/ pt first 15 - 30 minutes, assess Notify provider if Rx occur Complete in 2 - 4 hr to avoid bacterial grwoth ``` Vitals Dispose Monitor labs (CBC, Hgb, Hct) should rise approx. 1 g/dL per unit Chart Document response ```
27
Blood Trans and older pts (2)
Asses more frequently. | ↑ risk ▲ pulse, bp, rr, rx, overload, cardiac/renal fx
28
Use of Cardiac Monitor during Blood Trans.
Use to find MI
29
MI Age/EKG visual FX (6)
``` Start - ↓ T Hours - ↑ ST Hours+ - ↑↑ ST Hours - 2 days - ↑ ST + ↓ T Days - Weeks - ↓ Q and T Months - Years - ↓↓ Q only ```
30
Ischemia ♥ What is? Skin S/S EKG fx?
↓ O2 to ♥ Pallor ↓ T wave
31
Injury ♥ What is? Skin S/S EKG fx?
Ø perfusion b/c tissue dmg Cyanosis ↑ ST
32
Infarction ♥ What is? Skin S/S EKG fx?
Necrosis ♥ Black "Significant" Q wave
33
Acute MI ♥ Non ST Elevation MI (NSTEMI) What. EKG. ST Elevation MI (STEMI) What. EKG.
NSTEMI ▲ ST and T ind/ myocardia ischemia STEMI ↑ ST in 2 contiguous leads ind/ myocardial infarction/necrosis and req. intervention ASAP
34
Re/Depolarization
DE - AP when "-" cells develop charge. Ind/ ability to respond to stimuli by initiating impulse which r/in contraction RE - Return to baseline
35
P, PR segment, PR Interval, QRS Complex, and T waves
P - Atrial depolars. PR segment/interval - time from AV node to Ventricles PR interval - time from Atrial Depolars to Ventricles (P - R) QRS - time for Vent. Depolars (Q - R) T - ventricular Repolars.
36
MI Education (3)
Assess emotion Take care of self Treat angina w/ rest and 3 SL nitro. If f d/fx, seek medical attention
37
Baroreceptor Stimulation of Pts with HypoTN What is? Fx?
Receptors in arch of aorta that rx to ↑ BP | Inhibit vasomotor center in pons of medulla r/in ↓ BP
38
Fx Fibrinolytic Drugs
Clot busters ↓ MI, thrombosis, strokes, SOB (pind. clot) Give within first or after 6 hrs (+6 hrs r/in tissue dmg to ♥) Be aware of bleeding
39
Angina Pectoris Chronic Stable Angina (CSA) Unstable Angina
Imba. arteries in O2 supply to ♥, r/in ischemia Chest d/comfort w/ prolong exertion, assoc/w atherosclerotic plaque. Fix w/ rest/nitroglycerin Chest d/comrt @ rest. ↑# and level/time. >15 minutes, poorly tx'd w/ rest/nitroglycerin
40
Percutaneous Transluminal Cornoary Angioplasty (PTCA) | What is and Fx?
Stent used to re-open clotted artery with balloon.
41
``` PTCA Pt Care Look for... 3 S/S 2 Hypo 1 Dys 3 perscriptions ```
``` Look for S/S vessel closure... Chest pain Bleeding Rx to Contrast medium HypoTN, Kalemia, Dysrhythmias ``` Usually prescribed long-term nitrate/dual anti-platelet therapy (aspirin/thienopyridine) K supplements b/c HypoK
42
K Normal range and Fx of ↑ 4 ECG 4 Ectopic beats?
3.5 - 5.0 mEq/L ↑ ind/ ♥ block, Vfib, bradycardia, HypoHTN Tall T's, longer PRs, Flat Ps, Wide QRS Ectopic beats (beats outside conduction system)
43
Cardiac Markers (3)
Serum Markers Serum Cardiac Enzymes Serum Lipids
44
``` Serum Markers (2, 1) Ranges and ind/ ```
Troponins (↑ ind/ MI or Injury) | Troponin T -
45
Serum Cardiac Enzymes (2) | Ranges and ind/
Creatine Phosphokinase Myocardial Bands (CK-MBs) ↑ in/d MI occurs - 0% of total CK Creatine Kinase (CK) - ↑pind/ Myo, brain, skeletal injury or necrosis. ♀ 30 - 135 u/L ♂ 55 - 170 u/L
46
Serum Lipids (5)
Total - ↑ ind/ ↑% CAD 400 - 1000 mg/dL Cholesterol - ↑ ind/ ↑% CAD adult 122 - 200 mg/dL older adult 144 - 280 mg/dL (+70) Triglycerides - ↑ ind/ ↑% CAD ♀ - 35 - 135 mg/dL ♂ - 40 - 160 mg/dL LDL - ↑ ind/ ↑% CAD 60 - 80 mg/dL HDL - ↑ protects from CAD ♀ - >55 mg/dL ♂ - >45 mg/dL
47
Modifiable (4) vs. Nonmodifiable Fx
Cigarettes, inactivity, obesity, stress, BORN THIS WAY
48
Stroke Volume, Preload, Afterload
SV - blood ejected LV Preload - myofiber stretch @ end of diastole before contraction Afterload - pressure/resistance on Vents. b/c blood vessels
49
Infarction vs. Necrosis Infarction (2) Injury Zone Necrotic Zone THE IMAGE (3)
Infarction - necrosis or cell death r/t severe ischemia which can r/in necrosis Restore perfusion before irreversible! Injury zone - some survive/die Necrotic zone - die Ø restore r/in permanent scar tissue From inside to out... Area of necrosis Area of injury Area of ischemia

ABSN Cohort 19 (28 decks)

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