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NCLEX > module 3 > Flashcards

module 3 Flashcards

(108 cards)

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1
Q

pancreatitis

A

keeping the stomach empty and dry so that the pancreas stops releasing enzymes that are causing the pain in the first place

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2
Q

pancreatitis patho

A

endocrine: insulin
exocrine: digestive enzymes
causes: GB or alcohol
normally: eat - enzymes go to pancreatic duct - then to the intestine then activate
pancreatitis: obstruction - enzymes activate in the pancreas - auto digestion

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3
Q

BMI greater than 25 indicates

A

overweight or obese

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4
Q

DASH

A

diet appropriate to stop hypertension

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5
Q

pancreatitis s/s

A

s/s: pain that increases with eating, abdominal distension (ascites), swollen pancreas you can palpate
peritonitis- rigid board like abdomen, blood
grey turners- bruising flank cullens-bruising umbilicus
fever, n/a, jaundice, hypotension

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6
Q

orthopedics fractures s/s

A 
pain and tenderness
unnatural movement 
deformity
shortening of extremity
crepitus 
swelling  
discoloration 
worry about compartment syndrome **
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7
Q

fracture treatment

A

tx: immobilize adjacent joints and bone ends, support function above and below site, move as little as possible, splints help prevent fat emboli and muscle spasms, cover open function with sterile dressing
neuro vascular checks: pulse, color, movement, sensation, cap refill, temp

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8
Q

maternity s/s

A

presumptive: amenorrhea, nausea and vomiting, urinary frequency, breast tenderness
probable: + pregnancy test, goodell’s, chadwicks, hegar’s, uterine enlargement, pigmentation changes, braxton hicks
positive: FHR, ultrasound, fetal movement

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9
Q

Definitions : Gravidity

A

number of pregnancy

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10
Q

Definitions : Parity

A

number of pregnancy with 20 week fetus

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11
Q

Definitions : Viability

A

24 weeks gestation

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12
Q

Definitions : Naegele’s Rule

A

1st day of LMP + 7 DAYS - 3 MONTHS + 1 YEAR

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13
Q

TPAL

A

term, preterm, abortion, living children

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14
Q

clients with pancreatitis

A

keep stomach empty and dry

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15
Q

4 major functions of the liver

A

detoxify the body
helps your blood to clot
the liver helps to metabolize (break down) drugs
the liver synthesizes albumin

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16
Q

cirrhosis

A

liver cells are destroyed and are replaced with connective/scar tissue - alters the circulation within the liver- BP in the liver goes up (portal HTN)

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17
Q

if liver is sick…

A

decrease the dose of medications

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18
Q

enlarged spleen

A

immune system is involved

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19
Q

s/s of cirrhosis

A

firm, nodular liver, abdominal pain, spenaomegaly, decreease serum albumin, increase ALT & AST, anemia

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20
Q

when liver is sick

A

ammonia in the body increases

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21
Q

protein

A

breaks down to ammonia - liver converts ammonia to urea - kidneys excrete urea

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22
Q

hepatic coma
patho
s/s
treat

A

liver is impaired and cannot break down the ammonia so LOC goes down.
s/s: difficult to arouse, asterixis, decrease reflexes, EEG slow
tx: lactulose (decrease ammonia), decrease protein in diet, enemas

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23
Q

blackmore tube

A

balloon tamponade is for bleeding varices and it holds pressure on the bleed

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24
Q

peptic ulcers

patho, diagnosis, tx

A

common cause of gi bleeds
gastroscopy (EGD): npo pre and post procedure (when gag reflex returns), watching for pain, bleeding, trouble swallowing. upper GI: look at esophagus and stomach with dye. npo past midnight, no smoking, chewing gum, or mints
tx: anatacids- take on empty stomach, PPI (ZOLE), H2 (famotidine)

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25
may appear malnourished, pain is usually half hour - 1 hour after meals; food does not help, but vomiting does, vomit blood
gastic ulcers
26
appear well nourished, night time pain is common and also occurs 2-3 hours after meals; food helps; blood in stools
duodenal ulcers
27
hiatal hernia patho s/s tx
hole in diaphragm is too large so the stomach moves up into the thoracic cavity s/s: heartburn, regurg, dysphagia tx: small frequent meals, hob, sit up 1 hour after eating, surgery
28
dumping
stomach empties too quickly after eating and client experiences many s/s. lay down on left side, no fluids with meals, small/frequent meals
29
what side to lay on
left side= leaves food in the stomach | right side= releases the food
30
ulcerative colitis vs. crohns s/s
uc- ulcerative inflammatory bowel disease; in large intestine crohns- aka regional enteritis; inflammation and erosion of the ileum, but can be found anywhere in the small or large intestines s/s: diarrhea, rectal bleeding, dehydration, rebound tenderness, cramping, weight loss
31
coloscopy
clear liquid diet 12-24 hours pre procedure NPO 6-8 hours pre procedure avoid NSAIDS polyethylene glycol colon prep drank icy cold with no straw POST: watch for perforation (pain and unusual discomfort)
32
mcburneys point
RLQ appendix
33
TPN
central line needed, filter needs, may have to start taking insulin, gradual discontinue to avoid hypoglycemia, check urine for glucose or ketones only hung for 24 hours, change tubing with new bag
34
central line
position? tredelenberg to distend veins | if air gets in the line- left side, tredelenberg
35
with what type of fractures do you see fat embolisms or shock
long bones (Femur), pelvic fractures, crushing injuries
36
s/s of fat emboli
petechiae or rash over chest, conjunctival hemorrhage, snow storm on CXR
37
muscle becomes swollen and hard and the client reports severe pain that is not relieved with pain meds; pain is disproportionate to the injury could lead to amp
compartment syndrome
38
tx for compartment syndrome
if they have a cast, losen cast to restore circulatio
39
traction
never release it unless you have doc order
40
total hip replacement client education
neuro checks, monitor drains, firm mattress, trapeze bar overhead neutral rotation; limit flexion but want extension of the hips, isometric exercises , abduction avoid crossing legs or beding over; 1 day post op you can walk or when doc says walking/swimming/rocking; avoid flexion: low chairs, traveling long distances, sitting more than 30 mins, lefting heavy objects, stair climbing
41
how do you prevent contratures
extension!!!
42
what position would extend the hip or knee joints
prone
43
amputation
stump shaped cone, need a limb sock, massage stump
44
walker
you walk into a walker
45
crutches
up with the good leg, and down with the bad leg
46
canes
use on strong side of the body
47
hormone that induces amenorrhea
progesterone
48
softening of the cervix; second month
goodells
49
bluish color of the vaginal mucosa and cervix; 4th week
chadwicks
50
softening of the lower uterine segment; 2 or 3 month
hegars
51
contractions which occur throughout pregnancy; moves blood through the placenta
braxton hicks
52
mask of pregnancy
facial chloasma
53
bleeding, cramping, backache think
miscarriage
54
first trimester
``` 1-13 weeks expect weight gain 1-4 lbs folic acid- prevents neural tube defects always take iron with vitamin C do not let heart rate get above 140 ```
55
normal protein
40-45 | increases to 60 first trimester
56
danger signs and potential complication of maternity (8)
sudden gush of vaginal fluid, bleeding, abdominal pain, increase temps, persistent vomiting, edema, severe headache, no fetal movement
57
doc visits the first 28 weeks
once a month
58
doc visits 28-36 weeks
every 2 weeks or twice a month
59
ultrasounds
drink water before to distend the bladder | ultrasound before a procedure we want them to void
60
second trimester
``` weel 14-26 increase to 300 calories a day general 1 pound weight gain NO n/v, NO urinary frequency, YES breast tenderness FHR 110-160 ```
61
kegel exercises
exercise frequently to strengthen the pubococcygeal muscles; helps stop urine flow and keeps uterus from falling out
62
third trimester
27-40 weeks | no more than 1 pound a week
63
2 or more pounds a week we worry about
preclampsia
64
preclampsia
bp of 160/110 increased bp, proteinuria, edema mag sulfate
65
ruptured membranes think
prolapsed cord until proven otherwise
66
when should client go to the hospital
contractions are 5 minutes apart or when the membrane ruptures
67
non stress test
2 or more accelerations of 15 beats/ min or more without fetal movement want reactive because this means accelerations are present
68
biophysical profile test BPP
observation time is 30 mins by sonogram parameters count 2; 10/10 is perfect HR, muscle tone, movement, breathing and the amount of amniotic fluid around the baby
69
contraction stress test
performed on high risk pregnancies determines if the baby can handle the stress of uterine contraction NEGATIVE stress test is good
70
if blood flow decreases enough to cause hypoxia in the fetus, then the FHR will decrease from the baseline
deceleration
71
true labor
regular contractions pain increases contractions increase in frequency and duration
72
false labor
contractions irregular discomfort is in abdomen pain with change in activity decreases/goes away
73
steroid that helps the fetal lungs mature
betamethasone
74
epidural
lie on left side, legs flexed, prop up over the bedside | biggest complication hypotension
75
oxytocin
one on one care contraction rate 1 q 2-3 mins each lasting 60 seconds if late decels occur turn off oxytocin
76
tachycardia + postpartum think
hemorrhage
77
post partum uterus
fundus is midline below umbilicus
78
boggy uterus
massage the fundus until it is firm then check for bladder distension
79
lochia
rubra: 3-4 days and dark red serosa: 4-10 days and pinkish brown alba: 10-28 days and whitish yellow clots are ok as long as they are smaller than a nickel
80
babies immediate care
erythromycin to kill gono or chlamydia | phytonadione which is vitamin k and promotes formation of clotting factors
81
rh
rh+ blood from baby comes in contact with moms rh - blood mom looks at babys blood as a foreign body and the mom produces antibodies against rh + blood. first baby not affected. second baby will be. give mom rhogam within 72 hours after birth so she doesnt produce antibodies
82
rhogam must be given
before the antibodies form
83
3 rules for measuring abdominal girth
mark the abdomen so everyone measures the abdomen in the same place measure the abdomen at the area of the umbilicus or belly button measuring tape should be snug but not compress the skin
84
what levels will be elevated for acute pancreatitis
``` amylase lipase AST ALT PT and PTT glucose ```
85
h2 receptors
end in dine
86
with TNA check the urine for
ketones and glucose
87
s/s of too much ammonia
``` think SEDATIVE minor mental changes motor problems difficulty in awakening decreased reflexes handwriting changes slow EEG asterixis GO INTO A COMA HEPATIC COMA OR HEPATIC ENCEPHALOPATHY ```
88
should you give the liver client narcotics via IM route
no we are trying to prevent bleeding
89
priority assessment post paracentesis to be assessed for what
FVD by looking at the BP and pulse
90
immediately post tube feeding how would you place a client
right side HOB elevated
91
position post liver biopsy
right side to apply pressure to the puncture site
92
appendictis patient waiting to go to surgery what position should they be in
right side HOB elevated
93
gastric ulcers vs. duodenal
G- pain after meals, looks malnourished, hematemesis D- pain with empty stomach, looks nourished, blood in stool BOTH - antacids provide relief, avoid caffeine, medication for one year
94
what to monitor after an EGD
gag reflex, bleeding, swallowing, VS, pain
95
only occurs in the large intestine
ulcerative colitis
96
occurs anywhere in the body
crohns
97
tx for ulcerative colitis
low fiber diet, antibiotics, steroids, total colectomy
98
tx for crohns
try not to do surgery, low fiber diet, antibiotics, steriods
99
no insoluble fiber for crohns disease
just know; foods with skins are not good
100
with a potential leg fracture what 3 things should you do
1. immobilize the bone ends and adjacent joints 2. support the fracture above and below the site 3. move the leg as little as possible
101
before and after a splinting what do you need to do
a neurovascular check | pulse, color, movement, temp, sensation, cap refill
102
increase pressure with limited space
compartment syndrome
103
how do you know when a person develops compartment syndrome
pain that is not relieved with pain meds
104
difference between skin and skeletal traction
skin is short term (skin assessment is important) skeletal is long term (continuous traction, intact pins) both decrease muscle spasms, relieve pain, and immobilize fracture
105
term baby
38 weeks
106
a pregnant client with a rigid abdomen and uterine tenderness
placental abruption
107
if client has pre clampsia or eclampsia how long is she at risk for seizures after delivery
first 48 hours
108
newborn rr
30-60

NCLEX (17 decks)

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