RN Learning Systems Flashcards
(191 cards)
1
Q
Communication Dogs (You, Why, and I)
A
Dig for information, Tell the truth
NO YOU
NO Why?
Just I, and Clarify?
2
Q
Disaster occurs… first 2 priorities.
A
- Follow facility plan 2. Clear departments of non-urgent clients.
3
Q
3 key S/S of a MI
A
Sever epigastric and L arm pain + Diaphoresis
4
Q
2 Contraindications for the Small pox Vaccine?
A
Infants Immunocompromised
5
Q
Counter to nuclear/radiation terrorism
A
Potassium Iodide (Pima) Prevents thyroid gland from absorbing radiation, thus preventing cancer
6
Q
Most important factor of hand hygiene?
A
Friction
7
Q
Machine wigging out?
A
Restart or unplug/replug it.
8
Q
Angry co-worker?
A
Address them like a patient, but DO NOT ease their workload. Otherwise, GIVE IT TO EM STRAIGHT!
9
Q
Fresh Frozen Plasma. Function. What to monitor.
A
Rich in clotting factors used to treat acute clotting disorders. PT
10
Q
3 Expected S/S: dissecting aortic aneurysm
A
Blood loss at the heart… Tachycardia (to make up for flow) Hypotension (blood loss) Back pain
11
Q
3 Expected S/S: Fluid Volume Excess
Late S/S:
A
Jugular Vein Distention ↓ Hematocrit (↓ concentration b/c fluids) ↑ Heart Rate (make up for O2 flow)
Pitting Edema +3
12
Q
CHF w/ mitral stenosis - Dyspnea is caused by…?
A
Fluid accumulation in the lungs (Heart can’t pump
13
Q
The Heart
A
14
Q
Excepted S/S: Right Sided Heart Failure
A
Peripheral Edema
Right side of heart is where venous return is.
Weakness r/in poor output. Because input backflows, it gets stuck in the periphery.
15
Q
Expected S/S: Pericarditis
A
Dyspnea w/ a rapid RR
16
Q
How often should a patient exercise….? for ANYTHNG, really.
A
3x a week
17
Q
Expected S/S: MI 24 hrs ago
A
Ventricular Dysrhythmias
18
Q
TX: Hemophilia
A
Replacement of missing factor
19
Q
Expected S/S: Acute Angina Attack
A
Transient Abnormal PMI
20
Q
Blunt chest trauma commonly damages this portion of the heart
A
Right Ventricle
21
Q
2 Expected S/S: recent MI or CHF
A
Crackles, Frothy sputum
22
Q
Post vein ligation, stripping, or any VENOUS op/issue. Position for the client.
A
Supine w/ legs elevated 15º
23
Q
FX: Flaxseed Oil
A
Omega-3 Fatty Acids
24
Q
INFO: How long does Epoetin Alfa (Epogen, Procrit) take to take effect?
A
2 - 4 weeks
25
Expected EKG S/S: Atrial Flutter
Drastically higher Atrial Rate (P) than Ventrical Rate (QRS)
26
3 Expected S/S: Aplastic Anemia
Pancytopenia (↓ of WBC, RBC, and platelets), fatigue, and pale mucous membranes
27
FX: Hemophilia
Poor blood clotting
28
TX: Malignant Melanoma
What do they look like?
What to assess before biopsies?
Surgical Excision
6mm bluish-red lesions
Regional lymph nodes
29
Secondary nutrient (next to protein) that aids in healing
Vitamin C
30
What do these look like:
Papules
Macules
Wheals
Vesicles
small, solid, elevated (up to 10mm, like acne)
flat, variable shapes (up to 10mm, like freckles)
transient elevated (like hives)
elevated, containing fluid (chicken pox/herpes)
31
FX: Biological Dressings
Promote healing
32
Wound healing types:
Primary Intention
Secondary Intetnion
Tertiary Closure
Surgical closure
Left open to close on own
Left open and closed surgically later
33
Post-burn healing, what to avoid for a year?
Exposure to the sun
34
ADFX: Sulfadiazine Cream (Silvadine) for burns
Leukopenia 2 - 3 days beginning TX
35
Sun protection: How often to reapply sunscreen and strength SPF to use.
q2hrs, after swimming
At LEAST 15
36
TX: Snake bite?!
Immobilize the limb below the level of the heart
37
S/S potential malignancy in a basal cell carcinoma of surrounding moles.
Ulceration of moles.
38
FX: Type 1 vs. Type 2 DM
1 - pancreas does NOT produce insulin
2 - cells are resistant to insulin
39
TX: Somogyi Effect
Monitor glucose @ night
40
Cause of Acromegaly
Overproduction of Somatotropin
41
3 Expected S/S of a Thyroid Storm
Fever, HTN, Abdominal Pain
42
Diabetes and Exercise:
What to wear
When to eat?
Requirement to NOT exercise?
Always wear a Medical Alert Identification tag when doing so.
Eat within an hour if during insulin peak time
If Blood Glucose is ↑250, don't exercise
43
2 Key S/S: Diabetes Insipidus
Polydipsia (↑ thirst)
Polyuria (↑ urination) with low specific gravity
44
FX: Addison's Disease
Diet:
Lack of cortisol production
↑ salt, carbohydrates, protein, ↓ potassium
45
Post-Operative, patient's bowel sounds JUST return. What should first feeding be?
Water
46
Diverticulitis
Diet:
High fiber
47
Hepatitis A
Report:
Hepatitis B
Who gets the shot?
Anorexia - this occurs if liver releases toxins or it fails to detoxify an abnormal product
Infants and children
48
Shoulder pain post-laparoscopic procedures?
Caused by gas irritating the diaphram.
It will resolve in 1 - 2 days, but can be TX by mild analgesics and the recumbent position.
49
Pancreatitis:
Progression Amylase/Lipase levels
Amylase ↑ 3 - 6 hrs onset.
Peaks in 20 - 30 hrs, and returns to normal in 2 - 3 days.
Lipase stays elevated for 14 days longer than amylase.
50
Esophagoscopy:
Purpose
Determine how well the LES of esophagus works
51
Gamma-glutamyl Transferase (GGT)
Test used to determine possibility of alcohol use
52
Esophagogastroduodenoscopy
Purpose:
Visualization of Upper GI and cauterization of bleeding varices to prevent blood loss.
53
Balloon Tamponade for esophageal varices. How to react if pt becomes agitated, ↑ shallow RR?
Cut the tubing in front of the nose guard or sponge
54
2 Expected S/S: Bowel Perforation
Hypotension and Rigid Abdomen
55
Systemic Lupus Erythematosus (SLE)
3 Risk Factors:
How to TX wounds
Originates from what part of body:
Pregnancy, Infection, Sunlight
Apply moisturizer after bathing lesions in warm water
Connective Tissue
56
Expected S/S with Systemic Scleroderma
Finger contractures
57
Expected S/S: Kaposi Sarcoma
Reddish-purple lesions
58
Early & Late Lyme Disease (from ticks!)
S/S
Early S/S = progressive, circular rash
Late S/S = double vision, stiff/swollen joints
59
Expected S/S: Herpes Zoster
Unilateral, localized, nodular skin lesions
60
Most indiciative sign of a post-op infection?
Erythema at the site
61
Initial S/S: HIV vs. AIDS
```
HIV = flu-like symstomes (sore throat, fatigue, headache)
AIDS = persistent fever, swollen glands, diarrhea, weight loss
```
62
Histamines
FX:
↑ mucous secretion
63
FX of... (besides infection, ofc...)
Neutrophils
Lymphocytes
Monocytes
Eosinophils
stress and inflammation
infection (also cancer/malnourishment)
several collagen disorders
hypersensitivty/allergic RX
64
Skeletal Traction: If the client slips down and the weights are on the floor?
Help the pt use the trapeze to pull self up in bed
65
Skeletal Cast
TX for itchyness?
Blow cool air on it
66
Rheumatoid vs. Osteoarthritis
Nodes with Osteo?
Systemic, Autoimmune, and Bilateral vs. Local
Heberden's: distal, hard on bony swellings
67
Pulmonary Embolus
S/S
Tachycardia/pnea, Hypotension w/ rapidly dropping O2 Sat, post-fracture
68
Gout
Nodes?
Tophi
69
Alendronate Sodium
How to maximize absorption
Situp straight for 30 min
70
Eye surgery post-operative position
Prone w/ operated eye up
71
ADFX: Lasik Surgery (eye)
Halos and glaring when driving at night
72
Expected S/S: Autonomic Dysreflexia
A severe headache
73
Important piece of information regarding progression of neurological manifestations with an: Unruptured Arteriovenous Malformation (AVM)
Location of the AVM
74
TX: Swimmer's Ear + External Otitis
Instill diluted alcohol in the ear after swimming
75
Goal of TX: Transient Ischemic Attack
Prevent a CVA
76
Intracranial Pressure
2 Sign's that it is worsening
Widening blood pressure (160/65)
↓ pulse rate
77
FX: Guillian Barre Syndrome
Expected S/S
acute inflammation of peripheral nerves r/in ascending weakness (from the bottom, so starting in the lower extremities)
78
EDUCATION: Open Angle Glaucoma
Ø take cold medications containing pseudoephedrine
Expect imparied night vision
Driving = dangerous due to ↓ periphery
Laser Surgery can solve it
79
FX: Cheyne-Stokes Respirations
Indiciation of:
1 minute of breathing w/ 10 - 20 seconds of apnea or hyponea followed by respirations that ↑ in depth and frequency (cycle)
indicative of severe brain malfunction
80
4 S/S: Middle Ear infections
Sore throat, Pressure in Ear, ↓ hearing, diziness
81
3 S/S Bacterial meningitis in a Lumbar Puncture (LP)
Elevated protein and WBC
↓ glucose
82
FX: Amytrophic Lateral Sclerosis (ALS)
2 S/S
Progressive neurodegenerative disease that attacks motor nerve cells in brain/spinal cord. Neuronal death r/in distal muscle weakess and dysphagia
83
Decerebrate vs. Decorticate
84
FX: Mastoiditis
DX
Inflammation of temporal bone behind ear
Palpate mastoid process for tenderness, erythema, or edema
85
FX: Meniere's Disease
EDUCATION
Dz inner ear r/in poor balance/hearing, vertigo
Avoid sudden movements and other sensory input (watching TV and etc.) which will make S/S worse
86
FX: Myxedema
Swelling of skin r/in waxy look (r/t hypothyroidism)
87
FX: Rhinnorhea
Excessive mucus production of nose
88
Expected S/S: Tumor lysis
Flank pain
89
Carcinoembryonic Antigen (CEA) test is used to...
Monitor the progress of the disease in clients who are being treated
90
FX: Nadir
Lowest point of blood count after chemotherapy
91
FX: Hodgkin's Disease
Expected S/S
Cancer of lymph nodes
Enlarged lymph nodes
92
Bone Marrow Trasnplant: How it's Done?
Transfused just like any other blood component via a central IV line
93
EDUCATION: Females and bone marrow translplants
Take temperature 2x a day
Always wear shoes
Avoid using tampons
94
Expected S/S: Multiple myeloma
Thrombocytopenia
95
Expected S/S: Superior vena cava syndrome
Facial edema
96
FX: Cancer in Situ
Cancer within a local area that has NOT spread yet
97
FX: Intravesical Administration Therapy
Nurse Role:
Bacillus Calmeete Guerin (BCG) interferon alpha is instilled directly into the bladder for 2 hrs to prevent tumor growth
Assist the pt in changing positions q15min for the 2 hrs
98
NR: 24-hr creatinine clearance, if you accidentally discard a specimen?
Discard previously collected and START AGAIN!
99
Contraindication: Prostate Specific Antigen Test
Level progression w/ age
When to start getting screened
Fast prior to exam?
48 hours w/in a digital rectal exam
PSA values ↑ with age
50 years old
No need
100
Nurse Role: Pain during peritoneal dialysis
Change position (help dialysate solution drain from cavity)
101
Expected finding in urine: Upper UTI and Hyperglycemia
Casts (protein structures that precipitate in the renal tubules)
Ketones (associated w/ ketoacidosis)
102
REPORT: Extracorporeal Shockwave Lithotripsy (ESWL)
Arrhythmia (500 - 1500 shock waves are given in 30 - 45 minutes DURING the R wave, however if there is mistake, arrythmias occur and should be reported immediately)
103
Expected S/S: Cystocopy
Patient position during procedure
Pink-tinged urine with burning while urinating
Lithotomy position
104
Vasectomy
How long to wait before SEX?
Follow up tests
1 week
2 follow-up negative sperm counts (sperm is viable for up to 6 months)
105
3 Expected Findings: Transurethral Resection of the Prostate (TURP)
REPORT:
Pink urine, stress incontinence, retrograde ejaculation
Painful urination
106
2 Nurse Role: Renal Biopsy
Ensure pt is on bedrest for 4 - 12 hrs post procedure
Be NPO 8 hrs prior to the procedure
107
What nutrient do you WANT to ↑ w/ Chronic Renal Failure?
Calcium, as the kidneys can no longer activate them
108
Expected S/S: Flail Chest
Chest pulls inward on inspiration, outward on expiration
109
Expected S/S:
Acute Asthma Attack
Croup
Pulmonary inflammation (Pleurisy)
Pneumothorax/Air leak
Expiratory wheezing (narrowed airways)
Inspiratory Stridor (narrowed middle airway)
Pleural Friction Rub
Subcutaneous Emphysema/Absense of Breath sounds
110
Nurse Role: Trache Tube falls out?!
Re-insert it, LOL
111
FX: Pursed-Lip breathing
Eliminate CO2
112
FX: Allen's Test
Done before ABG draws...
compress both ulnar/radial arteries of the wrist until blanching occurs. Release, blood (color) should return to palm in 15 seconds. This indicates the ulnar artery can supply blood while the radial is used to draw.
113
Delusional Thinking is a form of...?
Projection
114
Denial
Repression
Introjection
Sublimination
voluntary emotional response to grief
involuntary forgetting of feelings
adopting characteristics of loved one
converting unacceptable things to socially acceptable activities
115
Projection
Displacement
Undoing
Convserion
own feelings on another
unacceptable emotions to a more acceptable substitute
doing opposite of unacceptable idea/act
Mental -\> physical symptoms
116
Splitting
Reaction Formation
Idealization
Others all either all good or all bad
Expressing attitude opposite of own wishes
Overestimating admired qualities of another
117
Transference
Countertransference
Self-evaluation
Client attributing feelings to nurse
Nurse unconsciously attributing feelings about another ot a client
Reflection of feelings and attitudes as they relate to the clients
118
Illusion
Confabulation
Delusion
misinterpretation of live experience
filling gaps in memory with fabrication (to avoid embarassment of memory loss)
False, fixed belief
119
FX: Munchausen Syndrome
Hurts child for attention
120
Expected SFX: Tricyclic Antidepressants
Drowsiness
121
What NOT to take with MAOIs
Pseudoephedrine (Sudafed), r/in HTN crises
122
What to watch for in Benzodiazepines
Addiction
Dizziness
123
S/S Tardive Dyskinesia
Involuntary grimacing, lip smacking, and tongue protrusion
124
DIET: Lithium
What ↑ toxcity?
Adequate sodium and fluid intake
Fasting
125
Defense Mechanism associated w/ Agoraphobia
Displacement
126
Bipolar drug thats OK with Pregos
Paroxetine (Paxil)
SSRIs are the LEAST harmful
127
Akathisia
Extra-Pyramidial Effect r/in pacing/figeting and restlessness
128
What makes Seroquel so fancy compared to other anti-psychotics?
Does not have the ADFX of weight gain
129
Defense mechanicsm r/t somatization disorder
Repression, repressing painful thoughts until they physically manifest
130
ANTIDOTE: Thioridazine Hydrochloride (Mallaril) ADFX of tremors, drooling, and restlessness
Benzotropine Mesylate
131
Defense mechanism associated w/ OCD
Undoing
132
Contraindication to Pertussis Vaccine
Known neurologic/seizure disorder
133
How to obtain a toddler's urine sample
Pediatric urine collector
134
Death to a Toddler is...?
EVERYTHING but permanent
135
Children: Tylenol and MMR
OK! Child will experience a low-grade fever and muscle ache after given vaccine
136
Toddlers: Easing anxiety of a procedure/hospitalization
Read books ABOUT the procedure or bring toys from home
137
Adolescent: Dormitory Vaccine for them!
Meningococcal Polysaccharide
138
Infant: Droplet Precautions
DO NOT have it leave the room w/ a mask
Don mask/gown when feeding it.
139
ANTIDOTE: Lead Poisoning
Drink milk
140
Toddler: When to expect crayon scribbling?
18 months
141
Infant Development:
Startle Reflex
Ability to sit w/out support, roll back and forth, reach for objects, and maybe EVEN CRAWL?!
Pull self up
Standing alone
Look around @ 8, scare @ 11
7 months
Start @ 8, stand by 11
9 - 11
142
FX: Oral steroids on children growth
SLOWS IT!
143
FX: Thalassemia Major
TX:
↓ production of oxygen carrying blood
Frequent transfusions
144
Expected S/S: Epiglotitis in a Toddler
Drooling
145
Expected S/S Acute glomerulonephritis
Hemouria
146
Diet: Cystic Fibrosis
↑ protein
147
FX: Ventriculo Peritoneal Shunt
Priority to address:
In brain to relieve fluids (hydrocephalus)
Sleepiness, difficult to arouse
148
FX: Koplik Spot
Vaccination timing
Oral blue/white lesions in mouse r/t Rubeola.
Appear 2 days before a rash/fever and flu-like S/S.
They usually fade afte rthe rash appears.
MMR - 15 months
149
DX: Intussusception
Pyloric Stenosis
Barium Enema
Upper GI Series
150
TX: Pinworms
Mebendazole (Vermox) 2 doses 1 week apart
151
FX: ASO Titer
Anti-Streptolysin
Determines if child had a recent strep infection which could r/in acute glomerulonephritis
152
FX: Myelomeningocele
Alteration of cerebral spinal fluid pathway, r/in hydrocephalus
153
Expected S/S: Tracheo Esohageal Fistula (TEF)
Copious oral secretions
154
EDUCATION: Plaster/Fiberglass casts
Place a plastic cover over it while bathing
If it gets wet, place a hair dryer on cool and a low setting to dry it
155
FX: 8 hrs post pyloromyotomy
DIET:
Release of a hypertrophied pyloric sphincter (no incisions made, so feeds can occur shortly post-operatively)
Small, frequent feeds
156
ADFX: Cardiac Catheterization
Blood on groin dressing (indicator of a potential hemorrhage)
157
FX: Prednisone (Deltasone)
↓ excretion of protein to help fluid shift back into normal spaces (extra fluid is excreting in urine). This decreases edema and r/in weight loss.
158
Vaccines and HIV
ALL OK!
Except Polio, screw you polio
159
EDUCATION: Steroid Inhaler (such as Cromolyn Sodium [Intal])
Use every day even if Ø manifestations
160
EDUCATION: Milwakee Brace for Scoliosis
You can only take it off for about an hour when you shower daily, otherwise WEAR IT YOU PUNK.
161
Expected S/S: Ventricular Septal Defect
Murmur best heard @ lower left sternal border
162
Nurse Role: Wilm's Tumor
DO NOT PALPATE ABDOMEN, THE WORLD MUST KNOW
163
Nurse Role: Spinal Fusion
Same as always, turn/roll q2hr
164
Medication for: Contraction Stress Test for pregnant women
Oxytocin (Pitocin)
165
TX: Ergotamine Tartrate (Ergomar)
2 Contraindications:
Migraine Headaches
HTN and Anemic pts
166
Contraindication: Ceftriaxone (Rocephin) and Penicillin
with each other.
and Piperacillin Sodium, which is a derivative of penicillin
167
FX: Superinfection
Similar to when a drug permits infection growth...
Such as antibiotics and candidiasis
168
FX: Tamoxifen (Nolvadex)
Anti-estrogenic (for pre-post menopausal women)
169
ADFX: Diphenoxylate and Atropin (Lomotil)
Megacolin (paralysis and dilation of bowel)
S/S tachycardia, hypotension, ↑BP, abdominal tenderness and cramping, reduction of diarrhea
170
FX: Metoclopramide (Reglan)
Contraindication
↓ vomitting post-operative/chemo and promotes gastric emptying...
SO not in a bowel obstruct patient!
171
FX: Prednisone
↑ Risk of?
Corticosteroid
Osteoporosis, r/in stress fractures
172
ADFX:Allopurinol (Zyloprim)
SFX:
Fever, stop taking.
N/V, GI distress, and a metallic taste in mouth
+ Drowsiness
173
iADFX: Gentamicin Sulfate (Garamycin)
Proteinuria (indicates renal damage)
174
Interaction: Chlorothiazide (Diuril) + Digoxin
↑ Digoxin Toxicity r/in hypokalemia which r/in muscle weakness
175
Nurse Role: Amitriptyline (Elavil)
ECG to obtain baseline CV status before therapy begins
176
Enteral feed @ half strength?
Add DOUBLE the amount of water.
Example: 8 oz Esure (1 oz = 30 mL)
240 mL Ensure + 240 mL water = 1/2 strength Ensure
177
FX: Filgastrim (Neupogen)
Glycoprotein - ↑ neutrophil count
often used in chemopatients who develop neutropenia
178
FX: Clopidogrel (Plavix)
Nurse Role:
Antithrombitic/platelet to prophylactically TX heart attacks and strokes.
Apply bleeding precautions due to anti-platelet FX
179
TX: Zolpidem (Ambien)
ADFX:
Insomnia (promotes sleep)
Confusion
180
Expected SFX: Rifampin (Rifadin) and Phenazopyridine (Pyridium)
Orange-Red body fluids (such as urine) - harmless!
181
Regular monitoring: Valproic Acid (Depakene)
Platelets (causes thrombocytopenia)
AST/ALT (liver function)
182
TX: ADFX of restlessness and involuntary movements of Hydrochloride (Thorazine)
Amantadine (Symmetrel) - Antiparkinsonian drug used to TX extrapyramidial side effects
183
FX: Buproprion (Wellbutrin)
Phenelzine (Nardil)
Hydroxine
Atypical antidepressant
MAOI antidepressant
Antihistamine - for mild/moderate anxiety
184
TX: Headache w/ peptic ulcer disease (PUD)
Acetaminophen (Tylenol), b/c it is an analgesic and not a NSAID, which would ↑ the r/o bleeding
185
3 Expected S/S: Reye's Syndrome
Contraindicated medication
Confusion, swelling brain, liver damage.
Aspirin (during viral illness)
AKA Reye-Johnson Syndrome
186
FX: Lactulose (Cephulac)
↓ serum ammonia levels
187
Hypertonic solutions
D5W, D5LR
188
Priority Assessment: Enalapril Maleate (Vasotec)
Blood pressure, because it ↓ BP
189
Monitor with: Gemfibrozil (Lopid)
Liver function
190
FX: Hydrochlorothiazide
TX:
EDUCATION:
Diuretic, makes you pee
HTN
Take in morning so you don't pee yourself, ya dingus
191
FX: Polycythemia
Abnormally high hemoglobin in blood
