TERMS & DEFINITIONS Flashcards
(107 cards)
1
Q
What is an Air Embolism and what causes it?
A
An obstruction caused by a bolus of air that enters the vein through an:
Inadequately primed IV line
Loose connection on an IV
During an IV tubing Change
Or through the removal of an IV line
2
Q
What is an Allen’s Test? How do we do it? Why do we do it?
A
A test that assesses the collateral circulation to the hand by evaluating the radial and ulnar arteries.
Done by asking the patient to make a fist, compressing either the ulnar and radial arteries of the lower forearm, ensuring that blood returns to the hand through the non-compressed artery.
This test is completed to ensure that an embolism does not exist in these arteries prior to the insertion of an arterial catheter.
3
Q
What does fluid volume deficit mean?
A
Dehydration, in which the fluid intake of the body does not match fluid loses/needs
4
Q
What is FFP (Fresh Frozen Plasma) used for?
A
Blood product administered to increase the level of clotting factors in clients with clotting deficiencies or as a plasma expander for plasma loss
5
Q
This helps regulate bone formation, blood coagulation, excitation of cardiac and smooth muscle, and the synthesis and regulation of the endocrine and exocrine glands.
A
Calcium
6
Q
This is concentrated in bone, cartilage and within cells and is a source of energy. It is needed for the factor of enzymes involved in carbohydrate metabolism, protein synthesis, nucleic acid synthesis, and contraction of muscular tissues.
A
Magnesium
7
Q
Define Metabolic Alkalosis. Name ways this can occur.
A
A deficit or loss of Hydrogen ions or acids and an excess of Bicarbonate that results from the concentration of alkalinic substances or the loss of acid without a compensatory mechanism.
Hypovolemia Loss of gastric fluids Excessive bicarbonate intake Massive transfusion of whole blood Hyperaldosteronism
8
Q
What are Packed Red Blood Cells?
A
A blood product used to replace Erythrocytes (RBCs) that were lost due to various complications.
9
Q
What is Phlebitis and how is it caused?
A
An inflammation of the vein that occurs from, mechanical, or chemical trauma, or local infections.
10
Q
This is needed for the generation of new bony tissues and functions in the metabolism of glucose and lipids, in the maintenance of acid-base balances, and the storage and transfer of energy from one site in the body to another.
A
Phosphorus
11
Q
Why might someone need a platelet transfusion?
A
Patients with low platelet counts or to thrombocytopenic patients who are bleeding actively or are scheduled for invasive procedures.
12
Q
This is found in intracellular fluids and is the primary buffer within the cell itself. It is required for nerve conduction, muscle functioning, acid-base balance, and osmotic pressure. Control the rate and force of cardiac muscle contraction and cardiac output.
A
Potassium
13
Q
Differentiate between Respiratory Acidosis and Respiratory Alkalosis.
A
Respiratory Acidosis
- A low concentration of a base that results from a higher concentration of hydrogen ions (acids) than the body can manage.
- Primarily caused by defects in respiratory function or changes in breathing patterns as the result of secondary problems.
- Caused by Understimulation of respiratory system (Bradypnea)
- Not getting enough O2 (base) and retaining CO2 (Acid)
Respiratory Alkalosis
- A Low concentration of carbonic acid or a decrease in the circulating hydrogen ions that results in the accumulation of base from the loss of acid without compensation.
- Occurs due to the overstimulation of the respiratory system (Tachypnea)
- Expiring too much CO2 (acid), and breathing in too much O2 (Base)
14
Q
What is septicemia?
A
The presence of infectious agents in the bloodstream.
15
Q
This abundant electrolyte mainatians osmotic pressure and acid-balance balance, and also transmits nerve impulses.
A
Sodium
16
Q
What is Herpes Zoster and what signs and symptoms might you expect from a patient with Herpes Zoster?
A
Shingles
Recurrent infection caused by dormant Varicella-zoster virus that occurred during chickenpox
Signs and symptoms: Unilateral clustering of skin vesicles along dermatomes Fever, malaise Burning and pain Paresthesia (pins and needles) Pruritus (itching)
17
Q
How do you treat Poison Ivy?
A
Cleanse skin of oils
Apply cold to reduce itching
Topical ointments to relieve itching and discomfort
Topical or oral glucocorticoids
18
Q
What is psoriasis?
What can precipitate it?
A
Chronic non-infectious skin inflammation causing psoriasis patches. Skin can break down and break; thus, leading to infection
Precipitated by: Stress Trauma Infection Hormones Obesity Autoimmune reaction Climate changes Genetic predisposition
19
Q
What is Stevens-Johnson Syndrome? Who does it most commonly effect?
A
Drug-induced reaction that occurs through an immunological response that can be mild or severe
May cause vesicles, erosions and crusts on the skin.
Most commonly occurs in cancer patients receiving chemo and immunotherapies.
20
Q
What are some initial emergency actions to take during a burn injury?
A
Assess airway Give oxygen Obtain vitals IV fluid replacement Elevate extremities burned Keep client warm & place on NPO
21
Q
Why would you want to elevate affected extremities in a burn patient?
A
It reduces fluid loss and subsequent hypovolemic shock from the burn injury.
22
Q
What symptoms would you expect from a patient who received carbon monoxide poisoning and has 55% carbon monoxide levels in their blood?
A
Coma
Seizures
23
Q
What is Leukemia?
A
Malignancy involving overproduction of leukocytes which usually remain at an immature stage in the bone marrow.
24
Q
What is lymphoma?
A
Classified as Hodgkin’s or Non-Hodgkin’s
Malignancy of the lymph nodes that is characterized by abnormal proliferation of lymphocytes.
25
What is the Difference between Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma?
If there is a presence of Reed-Sternberg Cells then it is Hodgkin's Lymphoma, if no Reed-Sternberg Cells are present, then it is Non-Hodgkin's Lymphoma.
26
What is Multiple Myeloma?
Malignant proliferation of PLASMA cells in the bone. Excessive proliferation of plasma cells invade the bone marrow and ultimately destroy the bone; invade lymph nodes, spleen and liver. Can lead to kidney failure due to increased Uric acid and calcium.
27
HPV posses an increased risk of which type of Cancer?
Cervical cancer
28
What is Syndrome of inappropriate antidiuretic hormone (SIADH)?
When a tumour produces and secretes or stimulates substances that mimic antidiuretic hormone. Leads to hyponatremia that can eventually cause seizures, coma and then death.
29
What is superior Vena Cava syndrome?
Occurs when SVC is compressed or obstructed by tumour growth. Early signs may be orbital puffiness and facial swelling in the morning, but can then extend to edema in the arms and hands, dyspnea, and nosebleeds in later stages.
30
What is tumour lysis syndrome?
Occurs when large quantities of tumour cells are destroyed rapidly and intracellular components like K+ and uric acid are released into the blood faster than the body can eliminate them.
Can indicate the treatment is destroying tumour cells, but if left untreated can cause severe tissue damage and death
31
What is Addisonian Crisis?
Adrenal hormone insufficiency that can be life-threatening. Can lead to shock and eventual death due to vascular collapse or hyperkalemia
32
What is the Chvostek's Sign?
Spasm of facial muscles caused by tapping the facial nerve in front of the ear.
Indicates hypocalcemia
33
This is known as the master gland and directly affects the function of all other endocrine glands
Pituitary gland
34
This gland secretes cortisol, cortisone and is responsible for glucose metabolism, fluid and electrolyte balance, and suppression of inflammatory response to injury.
Adrenal Gland
On top of the Kidney
35
What is diabetes insipidus?
The hyposecrretion of Antidiuretic hormone caused by a stroke or trauma or could be idiopathic. Much water is released
Kidney tubules fail to resorb water.
36
What is Addison's Disease characterized by?
Hyposecretion of the adrenal cortex hormones (Cortisol, cortisone, etc).
Fatal if untreated. (Addisonian Crisis)
37
What medications are given to a client with Addisonian Crisis?
Glucocorticoids (Cortisone, cortisol, dexamethasone, etc)
38
```
What is Cushing's Disease characterized as?
A/ Hypo-secretion of mineralocorticoids
B/ Hyper-secretion of glucocorticoids
C/ Excess secretion of ADH
D/ Hyper-secretion of aldosterone
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B/ Hyper-secretion of glucocorticoids
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Abnormal secretions of cortisol that leads to characteristics like:
moon face
Trunchal obesity
Buffalo hump
Thin arms and legs
Abdominal striae
```
39
What are catecholamines?
Hormones that illicit the fight-or-flight response. Epineprhine, norepinephrine and dopamine.
They increase Heart rate, blood pressure and blood glucose levels.
40
What symptoms may be seen in hypothyroidism?
```
Lethargy and fatigue
Weakness
Intolerance to cold
Weight gain
Dry skin and loss of body hair
Bradycardia
Constipation
Possible edema in the face and eyes
Loss of memory
menstural disturbances
Cardiac enlargement with a tendency to develop heart failure
Possible goiter
```
41
What is a Myxedema Coma? (MY-X-Edema)
Rare but serious disorder resulting from persistently low thyroid production. Very severe hypothyroidism caused by acute illness, rapid withdrawal of thyroid medication, anesthesia or surgery, hypothermia, or sedative and opioid use.
Can lead to respiratory failure and coma.
42
What are some symptoms of hyperthyroidism?
```
Personality changes: irritable, agitated, mood swings
Nervousness
Fine tremor of the hands
Heat intolerance
Weight loss
Smooth soft skin
Palpitations, cardiac dysrhythmias
Tachycardia and possible A-fib
Diarrhea
Protrusion of the eyes possible
Diaphoresis
Hypertension
```
43
What is a Thyroid Storm?
Severe and possible life-threatening condition that occurs in a client with uncontrollable hyperthyroidism
Can occur from severe stress or infections. Client will present with Fever, tachycardia, Systolic hypertension, agitation and anxiety, tremors, delirium and eventual coma.
44
Differentiate between type 1 diabetes and Type 2 diabetes?
Type 1:
Nearly absolute deficiency of insulin due to primary beta cell destruction.
If no insulin is given, client will experience DKA as fats becomes metabolized for energy.
Type 2:
Relative lack of insulin or resistence to the action of insulin
Insulin is usually insufficient; however, condition is preventable. Risk factors include:
Abdominal obesity
Hypertension
Low HDL levels
Hyperglycemia
45
What symptoms can be expected with hypoglycemia? What actions would the nurse take?
```
When blood glucose drops below 3mmol/L.
Symptoms can include:
MILD:
Hunger
nervousness
Palpitations
Sweating
Tachycardia
Tremors
MODERATE:
Confusion
Double vision
Drowsiness
Emotional changes
Headache
Irrational behaviour
Slurred speech
SEVERE:
Difficulty rousing
Disoriented
Loss of consciousness
Seizures
```
```
Treatment:
Check blood glucose levels
Give 10-15 g of carbohydrates or 1/2 cup of fruit juice
Check vitals
Retest sugars
Give additional snack if needed
```
46
What is Diabeteic Ketoacidosis (DKA)? What causes it? How do we treat it?
Life-threatening complication in type 1 diabetes that occurs due to a severe insulin deficiency. Manifested by Hyperglycemia, dehydration, and acidosis.
Fats become metabolized for energy resulting in the breakdown of fats resulting in the release of ketones and decreasing bodily pH (Acidosis)
Treatment includes:
IV Bolus of Normal Saline
IV Bolus of Insulin 5-10 units (May be used)
IV insulin for continuous infusion
Monitor Potassium levels as they will fail in the first hour of treatment - this is because Insulin binds to potassium and returns them to cells... so watch for rebound Hypokalemia and prepare a Potassium administration if needed.
47
What is Hyperglycemic Hyperosmolar Nonketonic Syndrome (HHNS)?
Extreme hyperglycemia without ketoacidosis. Occurs often in patients with Type 2 unlike DKA which if type 1. Treatment is similar to DKA:
IV Fluid Bolus
IV Bolus of Insulin (May be used)
IV Insulin through continuous infusion
Monitor K+ levels for rebound hypokalemia
48
What is Diabetic Retinopathy?
Chronic progressive impairment of retinal circulation that eventually causes hemorrhage. Permanent vision loss or damage can occur.
49
What is Diabetic Neuropathy?
```
Generalized deterioration of the nervous system throughout the body.
Complications include:
Non-healing ulcers of the feet
Gastric paresis
Erectile Dysfunction
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50
What condition would suspect in a patient presenting with the following signs and symptoms?
```
Severe pallor
Fatigue
Weight loss
Smooth Red tongue
Slight Jaundice
Tingling of the hands and feet
```
Vitamin B12 deficiency
51
What lab values would you suspect to be elevated in Hepatitis?
AST (Elevated by the thousands)
ALT (Elevated by the thousands)
Ammonia
Total Bilirubin
52
What is Crohn's Disease and what is it's trademark sign?
An inflammatory disease that can occur anywhere in the GI tract. Leads to thickening and scarring, narrowed lumen, fistulas, ulcers, and abscesses.
Trademark sign is Diarrhea that may contain mucus or pus.
53
Differentiate between Diverticulosis and Diverticulitis.
Diverticulosis:
Outpouching or herniation of intestinal mucosa, that can occur in any part of the intestine. Simply an outpouching of intestinal mucosa
Diverticulitis:
Similar to diverticulosis, except inflammation occurs from the penetration of fecal matter through the thinly walled diverticula. Can result in abscess formation and perforation.
Outpouching with bleeding and the trapping of fecal matter.
54
What is the purpose of Surfactant?
Phospholipid protein that reduces the surface tension of the alveoli; preventing alveoli from collapsing.
55
What is important to do when performing respiratory suctioning?
Hyperoxygenation of the client and not suctioning for more than 10 seconds.
56
What is the normal lab values for the following?
Pco2
HCO3
Pco2: 35-45 mmHg
HCO3 22-27 mEq/L
57
What type of mask would you use if you wanted to provide a patient with a specific amount of oxygen?
Venturi Mask
58
What is the difference between a high-pressure and low-pressure alarm on a mechanical ventilator?
High-Pressure Alarm:
Ventilator is experiencing increases resistance in the force against respirations
Maybe due to obstruction, coughing, gagging or biting.
Low-Pressure Alarm:
The ventilator is experiencing reduced pressure against respirations. Commonly due to a disconnection or leak in the tubing, or when the client stops spontaneously breathing.
59
What is Flail Chest? What are some interventions?
Occurs when blunt trauma causes a segment of the rib cage to fracture and become dislodged from normal structures. This part of the chest then expands and compresses with associated inspiration and expiration.
```
Interventions:
Maintain Fowler's Position**
Oxygen
Monitor for respiratory Distress
Encourage coughing and deep breathing
Analgesics
Prepare for mechanical ventilator if injury is severe (Prevents respiratory failure and shock)
```
60
What is Acute respiratory Distress Syndrome?
The accumulation of fluid in the Alveoli that impairs gas exchange.
61
What is Pleural Effusion?
A collection of fluid in the pleural spaces between the lung and surrounding tissues.
62
What is Empyema?
A Collection of pus in the pleural cavity between the lungs and surrounding tissues.
Antibiotics are used, along with a thoracentesis or chest tube.
63
What is Histoplasmosis?
A fungal infection caused by spores that enter the respiratory tract. Commonly found in contaminated soil or bird shit.
64
What is a tocolytic drug?
A drug that relaxes uterine activity and attempts to halt uterine contractions.
65
Why would a client at 30 weeks gestation be given Betamethasone or Dexamethasone?
Corticosteroids that increase the production of surfactant to accelerate fetal lung maturity and reduce the incident or severity of respiratory distress syndrome.
66
What is the action of prostaglandins for women in labour?
They ripen the cervix, making it softer and causing it to further dilate and efface. Helps to stimulate uterine contractions.
67
Why are Androgens like Testosterone and Methyltestosterone avoided in patients with Breast and prostate cancers?
Androgens increase tumour growth.
68
Why is INR and PT lab results conducted?
To assess the effectiveness of Warfarin therapy by measuring clotting time.
Normal values:
INR: 2-3 for warfarin therapy
PT 9.6-11.8 seconds
69
What is a normal range for platelet count?
150,000 - 400,000 cells/mm3
70
What is Creatine Kinase?
Enzyme found in muscles and brain tissue that reflect tissue catabolism resulting from trauma. Elevated levels reflect muscle damage and peaks around 18 hours.
```
CK-MB = Cardiac muscle
CK-BB = Brain tissue
CK-MM = Muscle tissue
```
71
What is Albumin? What does it do?
Main plasma protein of blood that transports bilirubin, fatty acids, hormones, and medications. It is a protein that acts as a shuttle for substances in the blood stream.
Values are increased during dehydration, diarrhea, carcinomas, infections, ascites, and alcoholism.
The normal range is 3.4-5 g/dL
72
What do AST and ALT measure?
Hepatic injury and inflammation.
73
What does creatinine measure? Increased levels indicate what clinical finding?
Indicator of renal functioning. Elevated Creatine signify slowing of the GFR and renal injury
74
What does excessive water bubbling in the water-seal chamber of a chest tube collection system indicate?
Air leak in the system.
Gentle bubbling is expected in the suction control chamber, NOT the water-seal chamber... think Seal.. nothing gets through.
75
What is coarctation of the Aorta?
A congenital defect that causes localized narrowing of the aorta in the aortic arch. Typically presents with hypertension in upper extremities with normal BP in lower extremities.
76
What 4 defects are included in Tetralogy of Fallot
1. Overriding Aorta
2. VSD
3. Pulmonary stenosis
4. Right Ventricular hypertrophy
77
What do you do with infants experiencing hypercyanotic episodes?
1. Knee-chest position - to assist in breathing
2. 100% oxygen
3. Morphine - reduces upper heart spasms
4. IV fluids - improves hydration
78
```
Which of the following will you NOT see in Rheumatic fever?
A/ Carditis
B/ Hypotension
C/ Arthralgia
D/ Erythema (Red skin lesions)
E/ Subcutaneous nodules
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B/ Hypotension
79
What is autonomic dysrelfexia? What can it lead to?
Potentially dangers and a lethal syndrome that develops as a result of a spinal cord injury that results in acute and uncontrolled hypertension.
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If untreated, it can lead to:
Seizures
Retinal hemorrhage
Pulmonary edema
MI
Cerebral hemorrhage
Death
```
80
What is Urine specific gravity used to measure?
A test to measure the concentration of urine and test how diluted it is. The high the number, the more dehydrated the patient is.
A normal range is 1.002 - 1.030
81
What is compartment syndrome?
It is excessive pressure build up inside an enclosed muscular space that usually results from bleeding or injury. High pressures impede blood flow and can make it an emergency situation.
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Treatment includes:
Pain medications
Oxygen therapy
IV fluids
Keeping affected limb below heart to increase circulation
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82
What is Afterload?
The force at which the heart has to pump against to effectively eject blood from the Left ventricle through the Aorta
83
State the location of each:
Tricuspid Valve
Mitral Valve
Pulmonic Valve
Aortic Valve
Tricupid:
Located on the right side of the heart
Empties blood from the right atrium to the Right ventricle
Mitral:
Located on the left side of the heart
Empties blood from the Left Atrium to the Left Ventricle
Pulmonic:
Lies between right ventricle and pulmonary artery
Shunts blood from the heart to the lungs by acting as a doorway to the pulmonary artery.
Opens during contraction to allow blood to leave the heart
Aortic:
Between the Left Ventricle and the Aorta
Acts as a door from the Left Ventricle to the Aorta
Opens during contraction to allow blood to leave the heart
84
What does the sympathetic nervous system release and how does it affect the heart?
Norepinephrine that produces tachycardia, increased conduction through the AV node, increased contractility, peripheral vasoconstriction
85
What does the parasympathetic nervous system release and how does it affect the heart?
Acetylcholine, that decreases heart rate, lessens contractions and conductivity of the natural pacemaker.
86
How does antidiuretic hormone effect Blood pressure?
Regulation of vascular volume.
When the antidiuretic hormone is released it causes the renal system to retain fluid, thus raising blood volume and as a result increasing BP.
Also the opposite effect, by withholding the secretion of antidiuretic hormone, the renal system excretes fluid, decreasing blood volume and as a result decreasing BP
87
How does Renin cause an increase in Blood Pressure?
Renin is a potent vasoconstrictor that is part of the RAAS system.
THE RAAS system releases aldosterone that promotes the retention of Na+ and H2O by the kidneys; thus, increasing blood volume and blood pressure.
88
What medication is crucial for patients with A-fib
Anticoagulants (Warfarin, Xarelto, Apixaban)
89
What medication may be used to treat Preventricular Contractions?
Amiodarone
Typically in association with MI or Myocardial ischemia
Amiodarone is known as an anti-arrhythmic drug. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat.
90
How do Calcium channel blockers act in Coronary artery disease?
Dilate coronary arteries and reduce vasospasm
91
What is cardiogenic shock defined as?
Failure of the heart to pump effectively to meet the demands of the body.
Can be due to Myocardial Infarction, Heart Failure, Pulmonary embolism, etc.
Typically seen when necrosis of more than 40% of the Left ventricle occurs, usually due to occlusion of a major coronary vessel.
92
Differentiate between Pericarditis, Myocarditis, and Endocarditis.
Pericarditis:
Inflammation of the pericardium (membrane that encases the heart.)
Heart failure or cardiac Tamponade can occur
Constricts the heart
Myocarditis:
Inflammation of the myocardium, typically due to pericarditis, systemic infection or allergic response.
Can lead to Heart failure, Thrmobus formation, cardiomyopathy (Diseases Heart muscle)
Endocarditis:
Inflammation of the inner ling of the heart and valves. Typically occurs in IV drug users, people with artificial valves, or cardiac defects.
Can lead to Heart failure or an embolism
93
What is Cardiac Tamponade?
Fluid buildup between the parietal and visceral layers of the pericardium (Space between the heart and the protective membrane that surrounds the heart).
Restricts ventricular filling and cardiac output therefore drops.
94
What is dilated cardiomyopathy?
Disorder of the heart muscles in which all chambers of the heart appear dilated and the muscular walls are thin. The condition is palliative only, there is no cure.
95
What is non-obstructive cardiomyopathy?
Disorder of the heart muscles in which hypertrophy of the cardiac walls and septum occur; thus, there is a significant decrease in chamber size.
96
Why kind of medication is Pradaxa? What side effect could occur?
Anticoagulant
Hemorrhage
Bleeding
Hypotension
97
Protamine sulfate is the antidote for:
Heparin & Enoxaparin
98
What is an acceptable INR reading for apatient on warfarin?
typically 2-3 is appropriate but can be as high at 3-4.5
Normal for a person not on warfarin is 1.3-2.0 INR
99
What is the antidote for Warfarin?
Vitamin K
100
What are some contraindications for the use of Thrombolytics?
```
Active internal bleeding
History of Hemorrhagic Stroke
Intracranial problems including trauma
Spinal surgery in previous 2 months
History of major surgery 10 days prior
Hepatic of renal disease
Uncontrolled Hypertension
```
101
What effect does Digoxin have on cardiac muscle?
Slows Heart rate
Slows conduction through the AV node
Forces heart to contract more efficiency
102
What is a therapeutic range for digoxin?
0.5-2 ng/mL
103
What do ACE-inhibitors like Enalapril or Ramipril do?
Vasodilates peripheral vessels
does this by blocking the conversion of angiotensin I to angiotensin II
104
What doAngiotensin II receptor blockers like Losartan and Valsartan do?
Vasodilate peripheral vessels and prevents secretion of aldosterone which will aid in the removal of fluid; thus decreasing blood pressure
105
What do β-blockers like Metoprolol do?
Inhibit β-adrenergic stimulation that increases cardiac output, blocks the release of catecholamines; thus reducing heart rate and Blood pressure
```
Basically,
Increases cardiac output
Decreases Blood pressure
Reduces Heart rate
And decreases oxygen demands of the heart by reducing its workload
```
106
What do calcium channel blockers like Amlodipine do?
Decreases cardiac contractility by relaxing smooth muscles; thus decreasing workload and oxygen needs for the heart
107
What is a myringotomy?
Surgical incision into the eardrum to relieve pressure or drain fluid. May be used in severe or chronic otitis media.
