Unit 4 Flashcards by Katherine Rodriguez

what do you hold before a patient is seen by dialysis?

hold blood thinners

hold Antihypertensives.

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what considerations do you want to do with a fistula?

ensure there is no bleeding
monitor Vitals
listen for the thrill
feel for the bruit

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what are some other considerations for dialysis patients?

daily weights

Labs

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what are some post Dialysis considerations ?

monitor vitals 
check for bleeding 
LOC
N/V
HA
muscle cramps. 
measure urine if any.

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what are some dietary considerations for dialysis patients?

Restrict fluid salt sodium
Low protein
Low potassium
Limit phos—take pills that bind to it

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what should you never do w/ dialysis patient?

Never take BP or any sticks in fistula arm

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elevated BUN and Elevated creatine is associated with what?

Dialysis LAB findings.

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what are some complications for dialysis patients ?

Edema
HTN
Bleeding from fistula

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Ensuring there is no bleed, feeling for a thrill and listening for bruit, checking the perfusion below
These are examples of care for what?

AV Fistula Care

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A patient initally showing up to the ER with s/s of pancreatitis will be put on what (nutrition wise) ?

NPO

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how can a pancreatitis patient receive nutrition?

NG tube

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what diet are pancreatitis patients on Once PO intake resumes?

low protein

High Fat

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what enzyme will break down food for pancreatitis?

Pancreatic Enzyme

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bruised and purple flanks are finding’s of what?

Turner Sign

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purplish discoloration around the belly button are findings of what?

Cullen Sign

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complications of pancreatitis are ?

N/v
sweating 
JUANDICE 
Weakness
HEMORRHAGE
turner sign 
cullen sign 
Peritonitis

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Excruciating Abd pain in epigastrium or LUQ

pain increasing with eating radiating to flank are findings of what?

Pancreatitis

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a Liver Biopsy is a definitive diagnosis of?

Cirrhosis

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what are some other way to diagnose cirrhosis?

Lab will show liver injury

AST / ALT

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what are some findings for Cirrhosis

Anorexia
Nausea
Weight loss
Ascites
Bruising
Cramping
Dull RUQ pain
GI bleeding
Itching
Jaundice—yellow skin

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A condition that collects fluid in your abdomen causing difficulties breathing is what ?

Ascites

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complications associated with cirrhosis include?

Clotting defects
Portal HTN
esophageal varices 
Hepatic encephalopathy 
hepatorenal syndrome
ascites

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Decreased LOC, confusion changes in handwriting , asterixis, bad breath from the body are indications of?

Hepatic Encephalopathy

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this condition is caused by elevated ammonia
s/s conclude of irritability , hyperventilation, can cause death or coma
is what condition

Hepatorenal Syndrome

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what are some teaching with cirrhosis ?

``` avoid acetaminophen avoid forceful coughing/straining later liver cirrhosis is irreversible fluid and sodium restrictions leading cause is excessive alcohol ingestion. ```

``` tight red skin over inflamed joints more common in men extreme pain at joint site common in big toe are finding of what ? ```

GOUT

what do you want to avoid with GOUT

Aspirin | Alcohol

what are some ttmt for gout

``` NSAIDS Steroids allurinol colchicine dietary management of weight increase water intake ```

this medication is given to reduce uric acid production

Allurinol

this medication is given to interrupt the cycle of crystal formation but does not affect

Colchicine

what are some teaching with Gout ?

``` common in men than women Caused by High protein Diet genetics caused by excessive alcohol drink cherry juice avoid red meat anything high in purine weight control Associated with kidney stone, diuretics and other drug therapy. ```

this medications prevents an attack of gouty arthritis and neuropathy ?

Zyloprim

Zyloprim considerations

avoid alcohol can take up 2-6 weeks to be effective Alkaline diet do decrease stone formation.

``` Anchovies Sardines Sweet bread Liver Red meats Kidneys are example of what diet and should be avoided for what disease? ```

Purines | Gout

Nursing care for leukemia ?

``` Monitor for infection monitor temp NO flowers or fruit baskets NO deli trays Neutropenic precaution monitor for abnormal bleeding d/t low platelet count diet monitor renal function Emotional support pain management education ```

what are some ttmts for leukemia ?

 Slowing growth of the abnormal blood cells  Maintain normal level of RBC, hemoglobin, platelets  Manage symptoms  Chemotherapy  Antineoplastic agents (anticancer drugs prevent or inhibit the maturation and proliferation of neoplasms)  Radiation  Bone marrow transplant  Biologics  No rectal temps

what should you NEVER do with leukemia patients?

RECTAL TEMP

sickle cells travel through small blood vessels, they can get stuck and clog the blood flow. This causes pain that can start suddenly, be mild to severe this is a sign of what?

sickle cell crisis

what are some findings of the expected findings of sickle cell anemia ?

```  Decreased RBC and HGB  Elevated bili  Skeletal x-ray may show joint and bone deformities-uneven bone growth  Hypoxia  Usually in a lot of pain ```

complication of sickle cell include ?

Hand and foot syndrome Jaundice due to increased bili Cholelithiasis Enlarged spleen or liver r/t retained cells and debris Hypoxia Stroke is common at a young age d/t blood clots Chronic pain

what are teachings to a sickle cell patient ?

``` drink plenty of water to reduce pain do not get to hot or to cold avoid High altitudes Avoid extreme exercise walk slowly Folic acid Diet No smoking, drugs or alcohol Adequate rest no cold therapy for sore joints ONLY hot therapy no physical activities ```

s/s include bleeding swollen painful joint=bleeding into the joins bleeding into muscle=swollen painful muscles what are these symptoms of?

Hemophilia

what is a major complication with hemophilia ?

``` Inter cranial bleeding Convulsions brain damage fatal bleeding into lungs fatal bleeding into neck causing obstruction of AIRWAY ```

what are some signs of ICB?

stroke like symptoms

how should you treat hemophilia ?

``` elevate injured part, apply ice packs control pain observe for any other bleeding stool softeners Demporessin analgesics and corticosteroids Psychological support ```

what should you never give to hemophilia patients?

NO enemas NO Aspirin NO Safety Razors

Headache Projectile vomiting decreased loc, irritability, restlness are findings of what?

ICP

whta are the early signs of ICP?

decreased LOC Irritability Restlessness

what is a classic sign of ICP

Projectile vomiting

what are some nursing care for ICP?

monitor Resp and other vitals | Keep HOB elevated

should you trendelenburg a ICP patient?

NOOOOOOO

primary prevention of head injury?

education

screening for a head injury is what kind of prevention?

secondary

treating the head injury is what prevention?

Tertiary

this dx cannot be seen, there will be no abnormalities detected on brain scan, it will look normal what is this?

Concussion

the Glasgow coma scale measures what?

LOC

``` dilation of pupil on one side stroke symptoms weakness Confusion headache lethargy are symptoms of ? ```

subdural hematoma

Unconsciousness at time of injury Brief lucid interaction decreased loc, HA n/v dilation of one pupil on affected side are s/s of ?

epidural hematoma

which is hematoma is more serious and fatal?

Epidural hematoma

what are some complications of hematomas?

``` brain herniation diabetes insipidus acute hydrocephalus labile vital signs ptsd Cognitive and personality changes ```

48 pulse 29 respirations 220/70 bp what does this bp represent ?

Crushing Triad

what is crushing triad is a medical emergency ?

yes, Bradycardia Irregular respirations Arterial hypertension (rising systolic while diastolic remains stable

Below normal body temp (<97) Mild: vigorous shivering, feeling cols, skin is cold to the touch, slurred speech Worsening: loss of coordination, shivering is replaced with muscle rigidity, loss of consciousness, death like appearance Some pts react different: some my become dizzy, get chills, SOB this is a sign of what ?

Hypothermia

Above the normal body temp (>100) Drink plenty of fluids, limit exertion, sit in shade Limit outdoor activity, stay indoors if weather is too hot, do outside activities closer to night time, use air conditioning Immediately place person in shade, cold water SPRINKLED on them, fan At hospital: remove clothing, wipe skin with cool cloth, ice packs to groin and under arms, cooling blanket, infuse cold fluids this is indicating what?

Hyperthermia

what should you do if the rectal body temp reaches 102.2 ?

stop all interventions

what are some frost bite interventions

warm the core FIRST DO NOT rub or massage frost bite NO alcohol or sedatives!! Warming extremities first can cause refreezing and this can cause more damage than prolonged freezing. Separate skin areas (fingers/toes) with sterile bandages, and elevate to level of the heart try to keep them from being out in the cold again

what does a high BUN indicate?

dehydration, poor kidney function, or an increased breakdown of proteins such as that which would occur with excessive burns, exercising, or low carb dieting.

what does a low BUN indicate?

liver damage excessive hydration or protein deficiency

7-20 are normal values of what?

BUN | Evaluate the kidneys

0.8-1.2 | are normal values of what ?

Creatine | evaluate the kidney dysfunction.

Male: 14-18 Female: 12-16 are normal values of what?

Hemoglobin

Male: 42%-52% Female: 37%-47% normal values of what lab?

Hematocrit

150,000-400,000 | is a normal count for what?

Platelets

5,000-10,000 | is a normal count for what?

WBC

Glomerular filtration Rate does what?

overall in depth lab of how well the kidneys are filtering.

Unit 4 Flashcards

(75 cards)