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M/S 2 Final

Levandowski Med/Surg 2 final

QuestionAnswer
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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