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Block 2 Exam 2 > Treatment > Flashcards

Treatment Flashcards

(83 cards)

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1
Q

AKI

A

Underlying cause
Fluid balance
Sodium polystyrene sulfonate, sorbitol, IV insulin/D50 for hyperkalemia
IV bicarbonate
Dialysis

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2
Q

AKI and CKD

A

Fluid balance (prevent excess)
Adequate nutrition (increase protein and calcium and vitamin D)
Education
Activity with rest
Prevent complications

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3
Q

FVE

A

I/O, weights
Limit fluid
Oral hygiene

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4
Q

ESKD

A

RRT
Dialysis
Kidney transplant

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5
Q

ESRD diet

A

4-5 small meals
Low salt
Low potassium
Low phosphorus
High protein
Limit fluids

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6
Q

Types of RRT

A

HD, CRRT, PD, Hemofiltration, hemodiafiltration

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7
Q

Kidney transplant contraindications for living donor

A

HTN and DM

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8
Q

Kidney transplant requirements

A

No infection
Anti rejection meds
Psychosocial evaluation

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9
Q

Sinus Brady

A

Change meds
Pacemaker
Atropine

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10
Q

Sinus tachy

A

Vagal maneuver
Meds: BB, CCB, adenosine

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11
Q

A fib drugs and devices

A

BB
Warfarin
Amiodarone
Cardioversion, ablation, watchman

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12
Q

Adjunct with meds for arrhythmias

A

Pacemakers
Cardioversion
Defibrillation

6 minute walk test

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13
Q

Prevention CAD

A

Lower cholesterol with diet and meds
Exercise
Stop smoke
Manage HTN
Control DM

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14
Q

Angina goal

A

Decrease oxygen demand and increase the supply
Reduce and control risk factors

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15
Q

Angina meds

A

Nitro
BB, CCB
Antiplatelet/anticoagulants- aspirin, clopidogrel and ticlopidine, heparin, glycoprotein inhibitors
May also need PPI, H2 for GI upset

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16
Q

MI

A

MOAN: morphine, oxygen, aspirin (ASA), nitro (NTG)
BB, heparin

PCI for STEMI
Thrombolytic (“plase”) if no PCI

Inpatient: cardiac monitor, meds, ASA and clopidogrel, BB, ACE ARB

Goals include: improve respiratory and perfusion

Nursing: oxygen, elevate head, IO, pain, frequent assessment and evaluation

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17
Q

Mitral regurgitation

A

HF treatment (BB, ACE, ARB)

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18
Q

Mitral stenosis

A

Anticoagulant, BB, CCB, digoxin

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19
Q

Aortic regurgitation

A

ACE, CCB
Valvuloplasty, valve replacement

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20
Q

Aortic stenosis procedures

A

TAVR (valve replacement), percutaneous valvuloplasty

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21
Q

Nursing for valvular heart disorders

A

Daily weights, activity with rest
(Along with typical monitor and med stuff)

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22
Q

Nursing for valve surgery (plasty or replacement)

A

Monitor for HF and emboli
(Along with typical perioperative stuff like VS, anesthesia recovery, stability)
Anticoagulant, prevent endocarditis, echoes

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23
Q

Cardiomyopathy nursing

A

Low Na, fluid restriction
Meds
Exercise, pacemaker
Rest with legs down, O2

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24
Q

Heart infection prevention

A

Abx and oral hygiene
Immunization

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25
Lower UTI prevention
Shower, hygiene, fluids, pee, vitamin C or cranberry juice
26
Lower UTI treatment
Fluids Avoid coffee, tea, citrus, cola, alcohol Abx and analgesics Heat
27
UTI hospital protocol
If no void 4-6 hrs/symptomatic, scan If scan >300 ml do straight cath Repeat if not fix Foley if still problem
28
Pyelonephritis
Usually outpatient Abx and fluids If chronic: strict IO and temp
29
Urolithiasis
Pain and infection control ID location and type Increase fluid - we want 2 L UOP Strain all UOP
30
Urolithiasis surgical procedures
Ureteroscopy, ESWL (shockwave lithotripsy), percutaneous nephrolithotomy, chemolysis with percutaneous nephrostomy
31
Bladder cancer
Radiation, chemo Surgery: transurethral resection “TURBT”, cystectomy with diversion Non invasive: TURBT then IVT then surveillance; lifestyle
32
Neobadder nursing
F and lytes and nutrition Prevent acidosis Catheter care, bladder retraining
33
Cutaneous diversion nursing
Monitor urine volume hourly Stoma and skin care Fluids Self care
34
BPH drugs and nursing
Alpha block (alfuzosin, tamsulosin, terazosin) Anti androgen (finasteride, dutasteride) Pain and spasm control Catheter for acute/unable to void
35
BPH surgical procedures
TUMT (transurethral microwave) TUNA (transurethral ablation) Resections: TURP, suprapubic, retropubic, transurethral incision
36
BPH post TURP care
CBI (continuous bladder irrigation) Pain control Monitor for hemorrhage and infection Early ambulating
37
Prostate cancer
ADT hormonal therapy Therapeutic vaccine Radiation and chemo Resection
38
Post prostate surgery mgmt
Treat if transurethral resection syndrome F and lyte Manage complications: hemorrhage, infection, VTE, catheter CBI
39
CBI mgmt
Titration high when red til clear then slow CBI infused - foley OP = UOP Bring in a back up bag
40
HF nursing and surgical options
Meds, lifestyle, O2 Surg: ICD (defibrillator device), valve repair, heart transplant
41
HF meds
Diuretics ACE, ARB, BB Ivabradine Hydralazine and isosorbide dinitrate Digoxin
42
Special considerations with treating HF older patient
Diuretics with BPH Drugs with decreased renal Atypical ss: fatigue, weak, somnolence
43
HF nursing
Activity with rest - 30 minutes, wait 2 hours after eating, avoid extremes Elevate head of bed Relieve fluid overload - weight, IO, diuretics, fluid and sodium restriction Treat comorbidities Education- include teachings on vaccines and infection prevention
44
Pulmonary edema
O2, NRB, CPAP, BiPAP Diuretics, dilators (nitro) Upright with dangly legs IO
45
Pericardial effusion and cardiac tamponade
Pericardiocentesis Pericardiotomy
46
Drugs for PAD
Phosphodiesterase inhibitor: cilostazol Antiplatelets Statins
47
Surg for PAD
Balloon angioplasty Stent Atherectomy Bypass graft
48
PAD nursing
Monitor pulses frequently ABI Exercise and SET program
49
Aneurysm management
Control HTN with BB, hydralazine, sodium nitroprusside for emergency Surgery
50
Abdominal aortic aneurysm
BB, CCB, ACE, ARB, diuretic Stent, removal with graft
51
DVT prevention
Early ambulation and leg exercises TED hose and SCDs Heparin, LMWH Lifestyle: weight, smoke, exercise
52
Pulmonary embolism drugs and surg
Unstable: thrombolytics, bypass surgery (rare) Stable: heparin gtt, LMWH, apixaban
53
Pulmonary embolism nursing
Monitor SpO2 Manage pain Monitor complications
54
Leg ulcers
Abx and analgesics Compression therapy Debridement Silver dressing Avoid heat Gradually progress activity Nutrition for healing- protein, vitamins A and C, iron, zinc
55
Cardiomyopathy surgery
Assist devices (VAD, LVAD) IAP (balloon pump) Total artificial heart as last resort Anti rejection drugs
56
Angina surgical options
Reperfusion therapy (PCI, stents, CABG)
57
Angina nursing
Rest, semi Fowler, assessment, meds, 2 L NC
58
Angina teaching
Stop smoking, low fat high fiber, carry nitro always, maintain good BP and blood sugar
59
Cholesterol drugs
Statins Bile acid sequestrants Nicotinic acids Cholesterol absorption inhibitors Omega 3 acid ethyl esters
60
DM
Nutrition Exercise Monitor Pharm Education
61
DM diet
50-60% carbs 20-30% fats <10% saturated <300 mg cholesterol Non animal proteins Increase fiber
62
Lower glycemic index
Combined with fats or proteins Raw or whole
63
Somogyi
Insulin adjustment Bedtime snack
64
Dawn phenomenon
No carbs before bed Insulin at bedtime
65
HHS
Rehydrate with iso or hypo Insulin with D5 Monitor f and lyte Tele
66
Diabetic nephropathy - drugs, diet, other
ACE, prevent UTI, low salt low protein diet, dialysis
67
Insulin drip protocol
100 units/ 100 mL 140-180 glucose Check glucose q1h D5W driver
68
Hypoglycemic mgmt
15-20 gram fast carb, 4-6 oz juice or soda, 3-4 glucose tabs Recheck 15 minutes later Retreat if necessary Snack with carb and protein unless meal in 30-60 minutes Intranasal glucagon
69
Emergency hypoglycemia treatment
<55 IM or SC 1 mg glucagon Fast carb and snack 25 to 50 mL D50 IV Ketone and glucose test strip education
70
SIADH
Furosemide, hypertonic IV if severe hyponatremia IO, weights, monitor labs, neuro
71
Hypothyroidism
Levothyroxine 75 to 150 mcg/day to start, then raise til labs are normal Activity intolerance, monitor for myxedema and constipation and chest pain (angina) Blankets but no heating pads Infection prevention (can lead to myxedema)
72
Hyperthyroidism
Small frequent Cool environment Monitor for storm, CV, resp, temp
73
Calcium foods
Dairy Seeds Leafy greens Almonds
74
Hypercalcemic crisis
Rapid high vol iso 100-150 ml/hr Calcitonin and mithramycin
75
Hyperparathyroidism
Avoid high calcium diet, increase fluid to avoid stones Monitor ss: stones, Ca crisis, apathy, fatigue, NVC, weak, HTN, arrhythmias Education on fracture prevention Increase exercise to move calcium into them bones
76
Hypoparathyroidism
Diet: high Ca low phosph (no spinach or dairy) Meds If giving Ca with dig monitor arrhythmia Monitor post neck surg for tetany, seizure, resp Seizure precautions
77
Thyroidectomy
Pre op: no caffeine, decrease stress to avoid storm Post op: airway/breathing, tracheostomy tray, drains for OP, ss bleeding, ice chips then soft/liquid, monitor Ca and phosph
78
Addison
Lifelong steroids Restore circulation/increase BP via 3-4 L NS or D5, hydrocortisone + vasopressors, abx for chronic immune suppression F and lytes, ortho hypo, fluids, IO
79
Addison crisis
IVF, glucose, lytes (Na), steroids, vasopressors
80
Cushing
Avoid injury, falls, infection, skin damage Cardiac Hypophysectomy/monitor Addison, radiation, taper steroids, insulin for hyperG
81
Potassium foods
Fruits and vegetables Legumes and whole grains Milk and meat
82
Phosphorus foods
Meat, dairy, beans
83
Post PCI assessment
We want… No chest pain Normal VS Normal neuro Normal heart Normal lung

Block 2 Exam 2 (6 decks)

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