Set 3 Flashcards
(122 cards)
1
Q
1st degree AV block
3rd degree AV block
A
1st. .. Prolonged PQ interval >0.2 sec
3rd. .. Atria and Ventricles contract independently
2
Q
Corticosteroid therapy teaching
A
- Do not stop abruptly
- Infection can come on quickly, report low grade temp to HCP
- Increase dose during times of stress
- Hyperglycemia is a side effect
- Diet high in calcium and protein, low in carbs and fat is recommended for increased muscle weakness and osteoporosis
- Cataracts are side effect. See eye doc yearly
- Do not take on empty stomach. Cause gastric irritation
3
Q
Expected side effects of lithium therapy
A
Lithium is used to treat bipolar disorder Side effects: -dry mouth -drowsiness -weight gain
4
Q
Chlorthalidone
A
Diuretic!!
5
Q
MAOI diet
What drugs are MAOI’s
A
No tyramine MAOI's include: -isocarboxazid -phenelzine -tranylcypromine -selegiline
6
Q
Clonidine
A
Do not stop taking abruptly.. taper over 2-4 days. Can cause rebound HTN
7
Q
Hydroxychloroquine adverse reaction
A
Retinal toxicity and visual disturbances
See eye doc every 6-12 months
8
Q
Clopidogrel
A
Anti-platelet (blood thinner)
9
Q
Contraceptive use adverse reactions
A
ACHES Abdominal pain - ischemic bowel Chest pain - PE or MI Headaches - stroke Eye problems - retinal blood vessel ischemia Severe leg pain - DVT
10
Q
Vancomycin and aminoglycosides adverse reactions
A
Ototoxicity and nephrotoxicity
11
Q
Aminoglycosides
A
gentamicin
amikacin
tobramycin
12
Q
Specific gravity
A
1.005-1.030
Elevated levels indicates concentrated urine and dehydration
13
Q
Calcium channel blockers
A
Promote relaxation of vascular smooth muscle.... decrease HTN nifedipine amlodipine felodipine nicaridipine
14
Q
Sulfonylurea drugs
A
Diabetic meds
glyburide
glipizide
glimepiride
15
Q
Manifestations of Neurogenic shock
A
Massive Vasodilation
- Hypotension
- Bradycardia
Warm dry skin common in neurogenic shock due to blood pooling in venous circulation
16
Q
Terazosin
A
Medication to treat BPH Side effect: -Orthostatic hypotension Teaching: -Take medication at bedtime to avoid dizziness
17
Q
Normal male hematocrit
Normal male hemoglobin
A
39-50%
13.2-17.3
18
Q
Symptoms of increased ammonia
A
Confusion
Give LACTULOSE. Lactulose decreases ammonia levels, so a therapeutic outcome of lactulose would be improved mental status
19
Q
Syphillis and pregnancy
A
STI
Crosses the placenta and can have teratogenic effects on the fetus
Prenatal treatment is IM penicillin
If pt has penicillin allergy, pt will have penicillin desensitization
20
Q
Doxycycline and pregnancy
A
Contraindicated in pregnancy. Can impair fetal bone mineralization and discolor permanent teeth
21
Q
Varicella
A
Chicken pox!!!
Not infectious once lesions are crusted over
Give Acyclovir
Can have a topical antihistamine such as benadryl applied to lesions
22
Q
UTI prevention
A
Do not use bubble bath or scented soaps. They cause irritation to urethra.
No bathing in antibacterial soap - reduce presence of normal flora
Use COTTON underwear! - Absorbs moisture (No nylon or spandex or tight clothing!)
23
Q
Expected weight loss for newborns after birth
A
5-6% of birth weight is lost within the first 3-4 days of life
24
Q
Expected findings at birth
A
Newborns tend to have cracked, peeling skin.
25
Steroids and BG
Steroids such as methylprednisolone will increase blood glucose
26
Seizure disorders and driving
Pt's with seizure disorders should avoid driving or operating heavy machinery until they have permission from their Dr.
27
Infant CPR
Deliver chest compressions with either two thumbs or two fingers on the sternum, just below the nipple line.
Check the brachial pulse for no longer than 10 seconds
Single rescuer should do a 30:2 compression to breath ratio
Two rescuers should do a 15:2 compression to breath ratio
If single rescuer to unwitnessed collapse, perform 2 min of CPR before getting AED
28
Agoraphobia vs social anxiety disorder
Fear or anxiety about being in or anticipating certain situations like a new job, being in a crowd, traveling on a bus or train, being in a tunnel or bridge, open or closed spaces. They are concerned about having "trouble escaping" or getting help if they have a panic attack.
Social anxiety disorder is fear of being embarrassed, observed, scrutinized in social settings.
29
Milk is rich in what two nutrients
Calcium and Vit D
30
Battery
Intentional touching of person without their consent.
Ex: administering morphine to a confused pt by telling them it is saline
Ex: putting in a needed catheter to a competent pt who is refusing it.
31
Tetralogy of Fallot
Put in knee chest position during hypercyanotic episodes
32
Tidaling occurs in what chamber of the chest tube
Water seal chamber. Tidaling occurs during the inspiration and expiration of the pt
33
Therapeutic magnesium level in a pt with eclampsia/preeclampsia
4.7 mEq/L
34
Drugs to prolong labor
Terbutaline, Magnesium Sulfate, Indomethacin, Nifedipine
| Suppress uterine contractions prolonging labor for 2-7 days
35
Ebola (viral hemorrhagic fever
Extremely contagious disease with high mortality rate
Standard, contact, droplet, and airborne precautions
- N95
-shoe covers
-face shield
-etc
Visitors are prohibited unless necessary. All visitors are logged and monitored for symptoms
Must be in airborne isolation room. Pt doesn't have to wear PPE but all visitors and staff do.
36
Low-residue diet
NO fiber
37
Megacolon
```
Common, life threatening complication of Inflammatory bowel disease
Manifestations
-Abdominal pain/distention
-Bloody diarrhea
-Shock
-fever
```
38
Blood thinners and surgery
Must discontinue 5-7 days before surgery
39
What is clopidogrel
Anti-platelet! So blood thinner
40
12 mo old vaccine schedule
Hib, PCV, MMR, Varicella, Hep A
41
Live vaccines
MMR, Varicella, Influenza nasal spray
Children who are immunocompromised should not receive live vaccines
Pregnant women should also not receive live vaccines
42
Goal A1c for diabetic clients
<7%
43
Vancomycin adverse effect
Can cause nephrotoxicity
| -Monitor creatinine levels daily
44
Contraindications for knee replacements
Recent or current infections!
45
Hemophilia
Hemophilia is a disorder characterized by a deficiency in the production of coagulation proteins
46
Tdap (Tetanus, diptheria, pertussis) during pregnancy
Pregnant women should receive between 27 wks and 36 wks
47
Epistaxis
Nose bleed
48
Drawing up insulin
Okay to mix NPH and regular insulin
| RN- draw up REG before NPH to avoid mixing
49
Atropine
Treats symptomatic bradycardia.
50
Hepatic encephalopathy
Complication of end stage liver disease
Result of inadequate detoxification of ammonia from the blood
Manifestations
-Confusion and lethargy
-Slurred speech
-Asterixis - flapping hand tremor that is found in hepatic encephalopathy
51
Rifaximin
ABX used to treat hepatic encephalopathy and IBS
52
Thyroid storm
```
Life threatening!
Immediately report any symptoms:
- Fever
- Anxiety
- tachycardia
```
53
IV opioid administration in pregnant women
Do not give when birth is imminent. May cause respiratory depression in baby!
May give when birth is still 2-4 hours out
54
Statin drug serious adverse affect
Rhabdomyolysis (pieces of muscle break off into the blood stream... may be fatal and cause kidney damage)
Report any muscle aches or weakness immediately
55
Normal PTT
| Therapeutic PTT
PTT is the lab value we monitor for heparin therapy
Normal 25-35
Therapeutic 46-70
56
Rifampin
Used to treat TB
| Side effect is that bodily fluids turn red-orange
57
Drugs that promote uterine tone after birth
Misoprostol, carboprost, methylergonovine
Methylergonovine is contraindicated in a pt with HTN
These drugs are used second line if fundal massage and oxytocin don't work
58
Carbidopa Levodopa fun fact
Turns urine and saliva colors (red, brown, black)
Dyskinesia (facial or eyelid twitching, tongue protrusion, facial grimacing) indicates an overdose of carbidopa levodopa and should be reported immediately
59
Theophylline
Bronchodilator with a low therapeutic index
Toxicity occurs at levels >20
Can cause seizures and life threatening arrhythmia's
60
Blood transfusions and voiding
Pt should void right before transfusion because if a reaction occurs, a fresh urine specimen will need to be collected to check for blood
61
Continuous IV drug infusions
RN not LPN
62
Antipsychotic side effects
| -Extrapyramidal side effects
- Acute dystonic reaction: sudden onset, sustained muscle contractions
- Akathisia: Subjective restlessness with inability to sit still
- Drug-induced parkinsonism: tremor, rigidity, masked face, brady kinesia
63
Antipsychotic side effects
| -Tardive dyskinesia
Involuntary movement after chronic use
- lip smacking
- stiff, jerky movements of arms
- rapid blinking
64
Antipsychotic side effects
| - Neuroleptic malignant syndrome
Fever, rigidity, mental status changes, autonomic instability
65
Preeclampsia
Characterized by:
-proteinuria 300 mg/24 hr period or protein to creatine ratio of 0.3
Frequent urination common in pregnancy in general, not preeclampsia
66
Thrombolytic therapy
```
used to dissolve blood clots
Contraindicated in :
-pt with recent surgery (within 14 days)
-pt with onset of symptoms >4 hours ago. Thrombolytic therapy is not effective if not administered within a 3-4.5 hour window from onset of symptoms.
-Thrombocytopenia (platelets <100,000)
-coagulation disorders
```
67
Celecoxib
NSAID!
68
NSAIDS
Increase risk of thrombotic events (MI, stroke) especially in patients with cardiovascular diseases (such as coronary artery disease)
69
Nitroglycerin action
Dilates blood vessels
| Headache is an expected side effect from vasodilation
70
Lithium toxicity
```
Narrow therapeutic index (0.6-1.2)
Levels >1.5 considered toxic
Drugs that can cause increased lithium levels:
-thiazide diuretics
-NSAIDS
-antidepressants
Low sodium precipitates lithium toxicity
```
71
ST segment elevation myocardial infarction (STEMI)
Occurs when coronary artery is completely occluded
72
HIV precautions
Standard
- no extra precautions are needed.
- HIV spreads when nonintact skin comes in contact with blood, breast milk, semen, or vaginal secretions
73
N95 mask
Should be used with tuberculosis and varicella-zoster
74
PaO2 levels
<60 indicates hypoxemia in COPD. Contact HCP!
75
Preeclampsia report to HCP
Hyperreflexia (3+ or greater) and clonus (rhythmic jerking beats of the foot) may indicate worsening and likely seizure activity
76
Assessing petechiae, jaundice, and cyanosis in dark skinned patients
Petechiae: conjunctiva of eyes and buccal mucosa
Jaundice: Palms of hands and soles of feet
Cyanosis: nail beds of fingers and toes
77
Stridor
Harsh, high pitched breathing
| Due to obstruction or constriction of large upper airway
78
Infections that can cause fetal abnormalities
```
TORCH
Toxoplasmosis
Other - parvovirus B19/varicella zoster virus
Rubella
Cytomegalovirus
Herpes
```
79
AED use
The quicker an AED is used, the higher the outcome. Do not delay use!
Remove transdermal patches and wipe the chest of the medication
Dry the chest area if wet before applying. The patient does not need to be completely dry. They can be lying in a small pool of water.
80
Care for patient with increased intracranial pressure
- Position the HOB 30 degrees (not on lots of pillows)
- Keep body midline
- Give stool softeners to prevent straining
81
Adenosine
Used to treat supraventricular tachycardia
82
Risk factors for pelvic inflammatory disease
Multiple sex partners
History of STI (specifically ghonorrhea or chlamydia) or PID
Partner with STI
Lack of consistent barrier method contraception
Age 15-25
83
Left or right lateral recovery position
Used for an unconscious patient who is still breathing
84
Hyperkalemia EKG
| Hypokalemia EKG
Hyper: Tall peaked T waves
Hypo: Inverted T wave
85
Diabetic Ketoacidosis treatment
Administer NS first! Then insulin. DKA patients are very dehydrated and need fluid replacement
86
First signs of fetal movement occur when
16-20 weeks, beginning to middle of of 2nd trimester
87
Allen's test
Test used to determine patency of ulnar artery to see if radial artery is good to use to draw blood gases.
Occlude both arteries, open fist, fist should be pale, release pressure from ulnar artery, if blood returns to the hand, test Is positive and radial artery is good to use.
88
Placental abruptions vs placental previa
Placental abruption occurs when the placenta detaches from the uterine wall causing hemorrhage.
Placental previa occurs when the placenta attaches over the cervical opening
89
Amnesia
Partial or total loss of memory
90
Gluten free foods
Rice, corn and potatoes are OKAY!
```
No BROW
Barley
Rye
Oats
Wheat
```
91
Cervical cancer ethnic most common
African americans
Hispanics
American Indians
92
HTN, Ischemic stroke and African Americans
African Americans have the highest incidence of HTN in the world. They also have higher rates of ischemic stroke.
93
Hodgkins lymphoma
```
Cancer that begins in the lymphatic system
Characterized by:
-enlarged, painless lymph node
-fever
-weight loss
-night sweats
-itching
-fatigue
```
94
Trazadone
Treats major depressive disorder, specifically insomnia associated with MDD.
Priapism (prolonged erection) is a common side effect
95
Normal fasting cholesterol
<200
96
Breastfeeding/newborns and HIV
Contraindicated in developed countries where good formula is available.
Infants born to HIV positive clients should receive antiretroviral therapy for 4-6 wks after birth
97
Holter monitor
Records a clients EKG for 24-48 hours
Things to note when using:
-Keep log of activities you are doing that day with any symptoms
-No bathing or showering during test period
98
Serotonin Syndrome
```
Caused by SSRI's
Manifestations:
-Clonus
-Tremors
-Diarrhea
-HTN
-Tachycardia
-Agitation
-Diaphoresis
```
99
NSAIDS
Ibuprofen
Naproxen
Ketorolac
Indomethacin
Meloxicam
NEPHROTOXIC - do not use in pt with kidney disease
Increase risk of thrombotic events (stroke, heart attack) in pt with cardiovascular disease!
100
Bell's Palsy
Just affects the face. Vision, Balance, Consciousness and extremity motor function are not affected
101
Rheumatic Fever
Acute inflammatory disease of the heart
| Occurs 2-3 weeks after streptococcal pharyngitis
102
Pleural effusion
Build up of fluid between lungs and lung sac
103
Regular insulin
```
Short acting (not rapid)
Peaks between 2-5 hours
```
104
Isosorbide dinitrate
Used to prevent angina in patients with coronary artery disease
105
Nystatin oral suspension
Soak dentures in nystatin solution
106
Common Respiratory tract infections in children
Croup - barking cough and stridor
Epiglottitis - dysphagia and drooling, sitting up and leaning forward
Bronchiolitis - wheezing
^^^ Common manifestations for each
107
Epiglottitis
Pediatric emergency
Requires intubation and possible tracheostomy
Characterized by dysphagia, drooling, sitting up and leaning forward
108
Croup
Characterised by barking cough and stridor
| Requires nebulized epinephrine with anesthesiologist standing by
109
Manifestations of septic shock
- fever or hypothermia
- hypotension
- prolonged cap refill
- tachycardia
- increased WBC
- decreased urine output
110
Cataract surgery post op teaching
```
Visual acuity won't improve for 1-2 wks
Common to experience itching, photophobia and pain in affected eye for several days
Avoid exercises that could increase intraocular pressure
-bending
-lifting more than 5 pounds
-straining
-sneezing
-coughing
-rubbing or placing pressure on eye
```
111
Phenytoin
Seizure medication
Therapeutic levels are 10-20
Early signs of toxicity: Gait unsteadiness and nystagmus (eye makes repeated uncontrolled movements)
Gingival hyperplasia (puffy and red gums) is an expected side effect
112
Oligohydramnios
Low amniotic fluid
Complications:
-undeveloped lungs
-umbilical chord compression
113
Hypomagnesemia
Can cause a lethal cardiac arrhythmia called torsades de pointes
114
Hemorrhagic stroke
Occurs when a blood vessel ruptures in the brain causing a bleeding into the brain
115
Opioid withdrawal vs use/overdose
Opioid use: constipation, lethargy, constricted pupils
| Withdrawal: tachycardia
116
Erythropoietin administration
Erythropoietin is what makes RBC's. It is a hormone produced by the kidneys.
Major ASE is HTN, uncontrolled HTN is a contraindication for erythropoietin administration.
117
CPR for pregnant client
Perform compressions slightly higher on sternum than usual.
Manually move uterus to the L, you may place pillows or blankets under pt to have them laying slightly on their L side to move the uterus.
If circulation does not return with 4 minutes, emergency C section, baby should be out within 5 minutes.
118
Oliguria
Very low urine output!
119
MAOI's and SSRI's
Should not be given together. Increased risk of life threatening adverse reactions
120
Atropine and adenosine
Atropine INCREASES heart rate. Given for bradycardia.
| Adenosine DECREASES heart rate. Given for SVT.
121
Bishop score
System that predicts if a pregnant patient will have a successful induction. A score of >6-8 indicates a successful induction.
122
Nonstress test
Test to determine if the fetus is well oxygenated. Reactive nonstress test means that the Fetus HR is 110-160, with moderate variability,
