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STATE EXAM PREP > part 1 > Flashcards

part 1 Flashcards

(111 cards)

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1
Q

Surgery classifications?

A

Elective
Diagnostic
Acute

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2
Q

List 3 patient orientated goals post surgery?

A

Return to normal physical function
Remain free from post op complications
Achieve emotional and physical comfort

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3
Q

What is included in a pre-op assessment? (5)

A

Obtain history
Physical assessment
Determine patient understanding
Identify emotional state and coping skills
Check consent, pre anaesthetic form complete, other pre anaesthetic orders

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4
Q

What does atelectasis mean?

A

Collapse or closure of lung resulting in reduced or absent gas exchange

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5
Q

List 5 ways to safely care for post op patients?

A 
Fluid balance input and output
Pain management
Assessing wound
Vital signs
Checking IV site
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6
Q

What is meningitis?

A

A serious disease in which there is inflammation of the meninges

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7
Q

Signs and symptoms of meningitis?

A

Intense headache
Fever
Light sensitivity
Muscular rigidity

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8
Q

Main cause of meningitis?

A

Bacterial: Streptococcus pneumoniae
Viral: Enterovirus

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9
Q

Signs of raised intercranial pressure? (4)

A

Headache
Nausea
Increased bp
Confusion

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10
Q

What is the purpose of the nursing council?

A

To protect the health and safety of members of the public by ensuring RNs are registered, fit to practise, and competent.

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11
Q

Signs of otitis? (Ear infection/inflammation)

A

Ear pain
Fever
Difficulty hearing

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12
Q

What would you do if prescribed medication was not signed by the doctor?

A

Do not give until a signature or verbal consent has been given with a witness

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13
Q

Signs of a patient on methamphetamine? (5)

A 
Dilated pupils
Agitation
Increased bp
Loss of appetite
Paranoia
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14
Q

List 5 pieces of advice to give a patient following a total hip replacement?

A 
Place a pillow between legs when lying on side
Avoid bending past 90 degrees
Avoid crossing legs
Sit on chairs higher than knee height
Take short frequent walks
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15
Q

What is airway obstruction caused by?

A 
inhaling or swallowing a foreign object
allergic reaction
trauma 
viral infections
bacterial infections
croup
inflammation/swelling
asthma
cystic fibrosis
COPD
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16
Q

Treatment for airway obstruction?

A 
Correct positioning
o2 therapy
Suctioning
Close monitoring
Viral signs
Anti emetics
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17
Q

S/S of atelectasis?

A

Insidious onset
Early s&s: cough, sputum, low grade fever
Later s&s: respiratory distress, dyspnoea, tachycardia, pleural pain, cyanosis, anxiety

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18
Q

What is a pulmonary embolism?

A

A condition in which one or more arteries in the lungs become blocked by a blood clot.
Most times, a pulmonary embolism is caused by blood clots that travel from the legs, or rarely, other parts of the body (deep vein thrombosis or DVT).

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19
Q

Diagnosis of a pulmonary embolism?

A 
Chest X-ray
Ecg
Abg
Ultra sound
Pulmonary angiography
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20
Q

How to prevent a pulmonary embolism?

A 
Pre op weight loss
Compression stockings
Early animation
Hydration
Meds
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21
Q

What causes a deep vein thrombosis?

A

Occurs in leg veins due to inactivity, body positioning, and pressure

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22
Q

Risk factors for DVTs?

A 
Elderly
Poor nutrition
Surgery over three hours
Limited mobility
Long haul flights
Diabetes
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23
Q

What is wound dehiscence?

A

Disruption/reopening of previously joined wound edges due to an infection, too tight sutures, or injury to wound

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24
Q

Risk factors for wound dehiscence?

A 
Elderly
Poor nutrition
Diabetes
Abdominal surgery
Immunosuppressant
Smoking
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25
Signs of wound inflammation?
``` Redness Warmth Malaise ( general discomfort) Tachycardia Febrile ```
26
List some side effects of opioid use?
``` Decreased bp Decreased LOC Vomitting Respiratory depression Constipation ```
27
What would you assume if someone's temperature was slightly lower post surgery?
This could be normal due to lack of muscle movement to keep body warm
28
What would you assume if someone's temperature was slightly higher post surgery?
This could be normal due to inflammation being the 1st sign of healing
29
What is autologous blood collection?
Providing blood for oneself
30
What fresh blood components are given in blood transfusions?
Red cells- used to treat anaemia, severe bleeding. Platelets- to stop bleeding, used in ICU or cancer treatment Fresh frozen plasma or cryoprecipitate- used for replacing clotting factors and rarely other blood proteins. Used in ICU or liver disease patients
31
Blood donations are always tested for?
``` Infection Hep B & C HIV & AIDS Syphilis ABO group Rh type Blood group antibodies ```
32
What cell is carefully checked before a blood transfusion for incompatibility?
RBCs
33
What is a blood crossmatch?
When a sample of the patients blood is used along with the donors blood for a transfusion
34
List some risks for blood transfusions?
``` Mild fever Skin rash Kidney failure Dyspnoea Minor virus infection ```
35
What type of burns are there?
``` Thermal Electrical Caustic chemical injury Radiation exposure Inhalation of noxious fumes ```
36
What occurs with a thermal burn?
Proteins denature Irreversible cellular damage occurs Acute inflammatory response
37
What is a 1st degree burn + what occurs?
``` Superficial partial thickness burn Damage to epidermis Triggers vasodilation Increased capillary permeability Heals within a week e.g sunburn ```
38
What is a 2nd degree burn and what occurs?
``` Deep partial thickness burn Damage to epidermal skin layers Penetrates some dermal skin layers Epidermal and dermal layers seperate + Fluor accumulate between Blisters form Scars form Healing takes 2-4 weeks ```
39
What is a 3rd degree burn and what occurs?
``` Full thickness burns Damage of the epidermis and dermis Can penetrate subcutaneous layers Destruction of blood vessels Scaring is extensive ```
40
What is shock?
A syndrome of circulatory failure and impaired perfusion to vital organs
41
What commonly occurs to bp in shock?
Hypotension
42
List the different kinds of shock?
``` Carcinogenic Hypovolemic Anaphylactic Septic Neurogenic ```
43
What occurs during cardiogenic shock?
Inadequate or inefficient cardiac pumping Causes low output & restricted movement of oxygenated blood throughout circulation Leads to systemic hypotension or pulmonary odema
44
How to treat cardiogenic shock?
Assess ECG & troponin levels Give aspirin, GTN, morphine, clopidogrel Give o2
45
What occurs during hypovolaemic shock?
Inadequate blood/plasma volume Reduced circulation Multiple organ failure
46
What causes hypovolemic shock?
Severe haemorrhage, burns, diarrhoea, poluria
47
How to treat hypovolaemic shock?
Apply pressure to wound if bleeding Blood plasma, rbc, or platelet transfusion Iv fluids antiametics
48
What occurs during anaphylactic shock?
Result of massive immune hypersensitivity response Vasodilation and increased vascular permeability Fluid leaves vascular space=swelling Bp and circulation is reduced
49
What is the treatment for anaphylactic shock?
Adrenaline
50
What is septic shock?
Systemic infection Chemical mediators produce inflammatory response Damages endothelial cells
51
What is the treatment for septic shock?
ICU admission | Iv abs
52
What causes neurogenic shock?
Result of brain or spinal injury, depressant action of certain drugs, anaesthesia, hypoglycaemia, or hypoxia
53
What occurs during neurogenic shock?
Neuronal transmission is altered Loss is sympathetic control of tension of blood vessels Unregulated vasodilation Decrease in vascular resistance, bp, and vital organ perfusion
54
What is the treatment for neurogenic shock?
Airway-jaw thrust manoeuvre Iv isotonic crystalloid solution Leg rolling onto a spine board
55
What are the pro's of using spinal anaesthetic?
Provides better pain relief (no analgesia for 24 hours post) Less bleeding during surgery so lower risk of developing clots You remain in full control of your breathing so lower risk of chest infection Less v+n+drowsiness post operation
56
Risks of spinal anesthesia?
``` Headache Dizziness Bladder problems Aches & pains Bruising ```
57
Risks of general anaesthetic?
``` Headache Sore throat N+V Dizziness Bladder problems Damage to lips & tongue Temporary confusion & memory loss Aches & pains ```
58
What should a pt be aware for at home following a total hip replacement?
``` Chest pain Calf pain SOB Fever or chills N+V Bleeding or discharge from dressing ```
59
What is the colon?
The first one and a half metres of the large bowel. It removes liquid from digested food and turns it into solid waste
60
What is the rectum?
The last 12-15cm of the bowel, ending at the anus
61
How common is bowel cancer?
One of the most common cancers amongst both men and woman. It may occur at any age although 90% is over 50 years
62
What causes bowel cancer?
``` Bowel polyps A high fat and protein and low fruit and veg diet Alcohol consumption Weight gain Low physical activity Family history ```
63
What is hereditary non-polyposis colorectal cancer? (HNPCC)
A condition where the tendency to develop cancer is inherited
64
What is familial adenomatous polyposis? (FAP)
A condition that causes hundreds of polyps in the bowel and if left untreated, always turns to bowel cancer
65
What is a disease of ten years that increase the chance of bowel cancer?
Chrohns
66
What is a colectomy?
Surgery to remove part of the bowel
67
What is a colostomy?
If the bowel cannot be rejoined the upper end is brought out onto the skin of the abdominal wall
68
What is an ileostomy?
When the end of the small bowel (ileum) or loop of the ileum is brought out onto the right side of the abdominal wall
69
What is removed during surgery for rectal cancer?
Tumour Surrounding rectal tissue Fatty tissue Mesentery
70
What is tonsellitis?
When the tonsils and pharynx which lie at the back of the throat become inflamed
71
Causes of tonsillitis?
Viruses (herpes simplex) | Bacteria (streptococcus)
72
Symptoms of tonsillitis?
``` Sore throat Swollen tonsils Fever Difficulty swallowing Swollen lymph nodes ```
73
Treatment of tonsillitis?
Virus cannot be treated by AB's Bacteria may be treated by AB's Food and fluids Tonsillectomy (surgical removal)
74
How long does it take to heal after a tonsillectomy?
10-14 days
75
What is the pyramidal motor system?
Extends from the sensorimotor areas of the brain to the motor neurone of the central horns of the spinal cord. Controls voluntary movement
76
What is the extrapyramidal system?
Basal ganglia. Fine tunes and stabilises movement
77
Mechanisms of injury?
Traumatic Ischaemic Pressure Excitation (electrolyte imbalance)
78
What is neuronal injury? + 3 examples
Anything that alters the stable neutron environment Sepsis Hypoxia Acidosis
79
What is a traumatic brain injury?
Traumatic force to the skull and brain
80
What is a closed head injury?
Skull is penetrated
81
What is a open head injury?
Brain tissue is exposed
82
What is the pathophysiology of a traumatic brain injury?
Disrupts intervertebral environment Altered brain function: neuron/axon injury Cerebral bruise, laceration, damage, haemorrhage may occur Damage to cerebral cortex lobes
83
What is raised intracranial pressure?
Decreased blood flow and displacement of brain tissue as well as increased pressure
84
Signs of a traumatic brain injury?
Decreased LOC | Altered motor responses
85
Signs of raised intracranial pressure?
Headache N+V Increased BP Confusion
86
Diagnostic criteria of a traumatic brain injury?
Hx and physical examination GCS score, LOC score Vitals X-ray
87
Treatment for a traumatic brain injury?
Preserve brain function Prevent secondary complications Stabilise cardio-respiratory function to maintain cerebral blood flow Decrease increased intracranial pressure and haemorrhage Meds Rehab
88
Risk factors for a stroke?
``` Genetics and age Hypertension and AF IHD and hyperlipidaemia Smoking and alcohol intake Obesity and inactivity ```
89
What is a stroke?
A clinical event causing impaired cerebral circulation
90
What are the 3 different strokes?
Thrombotic Embolic Haemorrhage
91
What occurs during a thrombotic stroke?
Cerebral artery occlusion often from atherosclerosis, commonly the middle cerebral artery (sensory or motor issues)
92
What occurs during an embolic stroke?
Travelling clot, commonly to brain or lungs
93
What occurs during a haemorrhagic stroke?
Bleeding. Caused by hypertensive arterioparthies, aneurisms, tumours, vasculitis, illicit drugs. Blood vessel ruptures
94
Recognising a TIA or stroke?
F-face-check smile or one side droopy A-arms-raise both arms is one side weak S-speech-slurred speech T-time-orientated to time
95
What is agosias?
When a patient can't recognise physical objects
96
What is aphasia?
loss of ability to understand or express speech, caused by brain damage.
97
What is expressive aphasia (Broca's area)
Problems formulating speech, thoughts, writing ability
98
What is receptive aphasia (Wernickes area)
Trouble with comprehension, can speak, may have word deafness or word blindness
99
Characteristics of left sided brain lesion?
Apasia Reading and writing problems Labels emotions
100
Diagnosis for a right/left sided brain lesion?
Hx and physical examination Lab results CT scan
101
Treatment for a brain lesion?
Reduce cerebral oedema and increased intracranial pressure | Rehab
102
What can degenerative disease cause?
Alterations in cognition, sensation, pain and motor responses
103
Pathology of Parkinson's disease?
A chronic, progressive, medical condition | Degeneration of pigmented dopaminergic neutrons of basal ganglia
104
What is neurotransmitter imbalance?
Manifestations due to overactive cholingeric neurons and lewey bodies
105
Cause of Parkinson's disease?
Unknown. Might be inherited
106
Signs and symptoms of Parkinson's disease?
Impaired motor function: tremor, rigidity, bradykinesia Autonomic nervous system responses: urinary retention, constipation Cognitive and personality changes Insomnia
107
What is the pharmacological treatment for Parkinson's?
Dopamine replacement Anticholinergic agents Paillidotomy (deep brain stimulation)
108
What causes Alzheimer's?
Unknown but believed to be environmental factors, mutated late onset genes (chromosome 19)
109
Pathophysiology if alzheimers?
Amyloid plaques glue up the correct Ray proteins form neurofibrillary tangles Neurons degenerate Neurotransmitter imbalance
110
Signs of Alzheimer's?
Cognitive decline Decreased problem solving Language loss Confusion
111
Treatment for Alzheimer's?
Maximize quality of life and promote general health status

STATE EXAM PREP (4 decks)

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