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M/S 2 Final
Levandowski Med/Surg 2 final
| Question | Answer |
|---|---|
| Seizures | keep suction at bedside |
| Status epilepticus | repeated seizures over 30 minutes |
| Tx for occurring seizure | Phenobarb, Valium, Dilantin |
| Alzheimer's | look at reaction to changing environment, follow the same schedule |
| Huntington's | jerky hand movements are common sign |
| Parkinson's | no production of dopamine, dopamine= voluntary movement |
| Parkinson's treatment | Sinemet (watch for dyskinesias) |
| Spinal Cord Injury | impaired physical mobility is safety issue |
| Spinal Cord Injury in ED | Airway first |
| MS treatment | treated with Medrol |
| Gullian-Barre | patient needs to be intubated |
| Plasmaphoresis | removal of circulating antibodies (used in tx of GBS) |
| Trigeminal neuralgia | excruciating pain in face, provide least amount of sensation to face, chew on unaffected side |
| Cerebrum trauma | causes memory loss |
| Frontal lobe injury | causes impaired judgment |
| hypoactive DTR | assist with walking b/c pt can't feel legs |
| Decorticate | hands in towards core |
| Pt has insulin pump and needs MRI | Cancel MRI |
| Lumbar Puncture at risk for complications | watch for restlessness/ agitation in patient before procedure |
| Lumbar Puncture results | should be crystal clear |
| Assessment after cardiac cath | pulses below site |
| U wave | shows electrolyte imbalance |
| Cardiac Output | amount of blood pumped from Left ventricle in one minute |
| Chest pain r/o MI | look at Troponins (T and I) |
| P waves | atrial depol |
| PR interval | 0.12-0.2 |
| Complete heart block (3rd degree) | pt needs external pacing |
| Left sided HF | dyspnea (and other respiratory symptoms) |
| Right sided HF | JVD, edema |
| Lasix | watch for K, K wasting (normal K is 3.5-5) |
| diruetics | look for serum K, it's potassium wasting |
| Prosthetic Heart Valve | watch for blood clots, form easily on prosthetics |
| Cardiac Tamponade Tx | pericaradiocentesis is needed to drain fluid |
| Cardiac dysrhythmia | heart cannot pump oxygen to organs and tissues |
| V Fibb | Defibb the V Fibb, electrical chaos in ventricles |
| Arterial insufficiency | causes pain |
| Care after cardiac cath | keep leg straight, look for hematoma |
| Arteriosclerosis | plaque on inside of artery walls |
| Atherosclerosis | hardening of artery |
| Sinus Tachy | greater than 100 bpm, it has a normal PQRS it's just fast |
| Interpreting Strips | Determine HR, P wave presence, PR interval, Interpret rhythm |
| Adenosin | brief asystole, used to stimulate regular heart rhythm |
| Run of V Tach | fatal rhythm, do ABCs and then shock |
| Buergers | no tobacco or nicotine |
| MI symptoms in women | usually asymptomatic, have indigestion or back pain |
| Beta Blockers | increase contractility of heart, increase cardiac output |
| MAP | needs to be greater than 60 for adequate tissue perfusion |
| PAD | characterized by intermittent claudation |
| 6 Ps of arterial insufficiency | Pain, parathesias, paralysis, pallor, pulselessness, and poikilothermia (can't maintain constant core body temp) |
| Strip reading (A Fibb) | no P wave, wiggly line on EKG where P wave should be |
| Strip reading- paroxysmal SVT | happens for short period of time, ventricles firing rapidly, ablation is done if meds don't work |
| Strip reading- Bigeminy | PVCs every other beat |
| Hypertrophy and hyperplasia | normal for cells |
| Estrogen | promotes growth of cancer in female reproductive system |
| Testosterone | promotes growth of cancer in male reproductive system |
| G1 | well differentiated |
| G4 | poorly differentiated |
| Cancers that are left untreated can cause | reduced immunity and blood producing functions, altered GI structure and function, motor and sensory deficits, decreased resp function |
| Palliative surgery | doesn't cure, just relieves symptoms |
| Purpose of radiation | kill cancer cells with limited exposure/effects on normal cells |
| S/E of radiation | fatigue, local/permanent hair loss, altered taste sensation, tissue fibrosis, scars |
| Instructions for pts with radiation | don't expose area to sun for 1 year, provide objective and accurate information, don't remove ink markings until radiation is complete |
| Important intervention for cancer patients | mouth care to prevent mucositis |
| Major complication of chemo | extravasation |
| tumor lysis syndrome | cancer cells killed so quickly that their waste products build up in the blood |
| Greatest risk factor for cancer | Age |
| Patients that need to be further evaluated for cancer | Patients with mouth sores that won't heal (think CAUTION) |
| Environmental factors | cause damage to cells and cause damaged cells to replicate |
| Breast cancer | most common neoplasm in women |
| neoplasm | abnormal growth of body tissue (think endometriosis and fibroids) |
| benign tumor cells | don't migrate, have small nuclear to cytoplasm ratio, orderly |
| cancer cells | have wrong number of chromosomes (aneuploidy), large nucleus to cytoplasm ratio, spread, loosely associated, don't look like parent cells (anaplasia) |
| Meds to give before chemo | Compazine, Zofran |
| Initiation | changes in cells resulting from intense and prolonged exposure to an external agent |
| Metastsized cancer | same kind of cancer as where it originated from |
| SVC syndrome | improved if swelling in hands has gone down (also if swelling in face goes down) |
| Mouth care for cancer patients | no alcohol based mouth wash, soft-bristled tooth brush, drink lots |
| antimetabolites | interferes with metabolism of cancer cells |
| antimitotics | interferes with cell division |
| antitumor | damages DNA |
| vesicant | damages skin, destroys tissues |
| Main cause of SIADH | lung cancer |
| Tx in dying patients- pain | prevent pain, give morphine |
| Pt with death rattle intervention | turn them on their side |
| dying patient is dyspnea | give morphine |
| Don't talk about this in front of dying patient's family | religion |
Created by:
rwrigh17
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