- ensure its not bleeding - feel for thrill and listen for bruit - check perfusion below fistula

Unit 4 Flashcards by Krissa Thrift

Vibration in a fistula

Thrill

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Soft swishing in a fistula

bruit

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Things to monitor for after dialysis

ensure fistula is not bleeding
monitor vitals
LOC
N/V
HA
muscle cramps

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Medicines to withold before dialysis

Blood thinners and antihypertensives

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Dietary considerations for kidney disease patients

Restrict fluid, sodium, phos

low protein and potassium

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What labs are elevated in kidney disease patients

BUN and creatinine

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What do you always need to ask a kidney disease patient?

If they produce urine and you NEED to measure it

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AV fistula care

ensure its not bleeding
feel for thrill and listen for bruit
check perfusion below fistula

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Nutrition for pancreatitis patients

Pt may be NPO to give pancrease a break
low protein, high fat once PO diet resumes
Enzymes WILL be given EVERY time they eat.

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Sign of hemorrhage in pancreatitis. Flanks are going to be bruised and purple.

Turners sign

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Sign of hemorrhage in pancreatitis. Purplish discoloration around belly botton.

Cullen sign

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What is the most accurate way to diagnose cirrhosis of the liver?

Liver biopsy

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Patient dispays the following:

	Anorexia
	Nausea
	Weight loss
	Ascites
	Bruising
	Cramping
	Dull RUQ pain
	GI bleeding
	Itching
	Jaundice

What do you suspect the dx to be?

Cirrhosis

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this is a result of portal HTN, enlarged blood vessels in the esophagus with thin walls that may tear easily and cause severe bleeding and death THIS IS AN EMERGENCY CALL 911

esophageal varices

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this is caused by liver scarring obstructs blood flow in the portal vein causing pressure to build in the surrounding vessels

portal HTN

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S/S are decreaed LOC, confusion, changes in handwriting, asterixis (flapping hand tremor), bad breath from the body

hepatic encehalopathy

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Flapping hand tremor

asterixis

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caused by elevated ammonia. S/S: confusion, asterix, fector hepaticus (foul breath from body not dentition), irritability, hyperventilation. Can cause coma and death

hepatorenal syndrome

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accumulation of fluid in the peritoneal cavity. Causes difficulty breathing

ascites

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Cirrhosis patients should avoid taking what for a headache?

tylenol or anything with acetaminophen

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Cirrhosis patients are on what kinf od dietary restrictions

FLuid and sodium

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Tight red skin over inflamed joints
occurs more in med
extreme pain at joint site; most common in big toe

Gout

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Gout patients can take any NSAID except…

Apsirin

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Cirrhosis patients will probably be taking stool softeners becuase

they have to avoid coughing and straining

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Things that can cause gout

high protein diet genetics excessive alcohol High purine foods

High purine foods

``` anchovies sardines sweet breads liver red meat kidneys ```

How long might it take to see imprivement when taking zyliprim?

2-6 wks

How should allopurinol be taken?

with food or milk to avoid GI irritation

Should NSAIDs be taken with zyliprim? why or why not?

yes bc zyliprim is for prevention of actue gout attacks not the tx of them

What kind of precautions should a leukemia pt be on?

neutropenic

What is common among pts diagnosed with sickle cell even young patients

Stroke

Things to avoid with leukemia patients

``` deli trays flowers rectal temps high altitudes drugs and alcohol extreme exercise cold therapy ```

What should you encourage sickle cell patients to do?

drink plenty of water

Diet for sickle cell patients

folic acid: to help body make new cells | sufficient protein: to build up RBC

S/S of intercranial bleeding

Stroke s/s

What NSAID should hemophillia pts avoid

aspirin

A hemophillia pt has a swollen painful joint...what do you suspect

bleeding into the joints

A hemophillia pt has swollen painful muscles

bleeding into muscle

Drug used to stimulate clotting factors for hemophilia pts

desmopressin

Before any dental or invasive procedure, what should you ensure to do for a hemophilia pt?

prophylactic factor tx

If a hemophilia pt has a hx of constipation what should you and should you not do?

NO enemas or suppositories!! | YES stool softeners

``` Pt displays: headache projectile vomiting decreased LOC irritability restlessness ``` What do you suspect?

Increased intracranial pressure

Early S/S of increased intracranial pressure

decreased LOC irritability restlessness

Can a concussion be seen on a brain scan?

NO! | It will look normal!

Pt presents with stroke symptoms, weakness, confusion, headache, lethargy, and dialation of pupil on one side what so you suspect?

subdural hematoma

Pt was unconsciousness at time of injury, breif lucid interactions followed by decreasing LOC, HA, N/V, dialation of one pupil (on affected side) what do you suspect?

epidural hematoma

What is most concerning: subdural hematoma epidural hematoma?

epidural

S/S of crushing triad

Bradycardia Irregular respirations Arterial hypertension

rising systolic while diastolic remains stabe

arterial hypertension

body temp less than 97 | vigorous shivering, feeling cols, skin is cold to the touch, slurred speech

mild hypothermia

body temp less than 97 | loss of coordination, shivering is replaced with muscle rigidity, loss of consciousness, death like appearance

worsening hypothermia

Tx and interventions for hyperthermia

 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  When rectal temp reaches 102.2 what do you do???

Frostbite interventions

 Do not rub/massage frost bite!!  Warm the core first!!  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  No alcohol no sedatives

Hemoglobin

Male: 14-18 Female: 12-16

Hematocrit

Male: 42%-52% Female: 37%-47%

platelet count

150,000-400,000

WBC count

5,000-10,000

High BUN

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

Low BUN

liver damage excessive hydration or protein deficiency | Creatinine 0.8-1.2; evaluates kidney dysfunction

GFR measures

how well the kidneys are functioning

BUN levels

7-20 | evaluates how well the kidneys function

Creatinine

0.8-1.2 | evaluates kidney dysfunction

Unit 4 Flashcards

(62 cards)