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Med Surg II
Ch 17, 30, 31, 32
| Question | Answer |
|---|---|
| Name the 4 types of shock: | Hypovolemic, Distributive, Obstructive, Cardiogenic |
| Distributive shock can be broken into 3 categories: | Neurogenic, Septic, and Anaphylactic |
| What is the most common type of shock? | Hypovolemic Shock |
| What are 2 causes of hypovolemic shock? | Blood and fluid loss. |
| What is the number one cause of heart failure? | Myocardial Infarction |
| A major cause of ___________ shock is massive vasodilation. | Distributive |
| What are the s/sx of sepsis? | Elevated temp., bounding pulse, tachycardia, flushed skin, elevated WBC. |
| What are endotoxins? | bacterial waste |
| What is SIRS? | Inflammation without a proven source of infection, it precedes septic shock. Early detection is vital. |
| What medication is used to treat anaphylactic shock? | Epinephrine |
| Examples of obstructive shock: | Cardiac tamponade, tension pneumothorax, ascites, hepatomegaly, pulmonary embolus |
| When hypoxia occurs at a cellular level, there is a build up of ____________. | Lactic Acid |
| What is the number one cause of ARDS? | Septic Shock |
| What is the first organ to fail r/t shock? | Kidneys |
| What lab tests are run to determine kidney function? | Creatinine, BUN |
| Decreased urine output is indicative of ________ _______. | Kidney failure |
| What labs are run to determine liver function? | AST, ALT |
| What happens to a cell if there is too much sodium? | The cell dies, leading to tissue death. |
| During stage 1 (compensation) of shock, what trends will the nurse see in the VS? | Decreased BP, increased temp/pulse/respirations |
| What are the s/sx of stage 2 (decompensation) of shock? | Decreased BP, HR, peristalsis, and urine output, cold/pale skin, lethargic |
| Lactate greater than ____ is indicative of shock. | 2 |
| Normal digoxin level: | 0.5-2 |
| If a pt is given vasopressors, how often should the nurse monitor VS? | q 5 minutes |
| Name 2 positive inotropic agents: | dobutamine, digoxin |
| When are vasopressors given to a pt in shock? | Vasopressors are given to a pt after fluid resuccitation. |
| What is the main role of the lymphatic system? | Mature lymphocytes |
| Expected WBC: | 5,000-10,000 |
| Expected iron range for female: | 60-160 |
| Expected iron range for male: | 80-180 |
| Expected platelet count: | 150,000-400,000 |
| Desired INR range for a pt on warfarin therapy: | 2-3sec |
| Expected PT range: | 11-12.5 sec |
| Expected INR range: | 0.8-1.1 sec |
| Expected aPTT range: | 30-40 sec |
| Expected Hct range for Female: | 37-47% |
| Expected Hct range for Male: | 42-52% |
| Expected Hgb range for Female: | 12-16 |
| Expected Hgb range for Male: | 14-18 |
| If bilirubin is too high, what can it do to infants? | Elevated bilirubin can become toxic to the brain if left untreated. |
| Natural heparin is secreted by which of the granulocytes? | Basophils |
| What is bilirubin? | Bilirubin is residual pigment from destroyed erythrocytes. |
| What is the life span of a leukocyte? | 1-2 days d/t high demand |
| Thrombocytes have a life span of 7.5 days, where are they produced? | Red bone marrow |
| What is the make up of plasma? | 90% water, 10% proteins |
| What is fibrogen responsible for? | Forming blood clots. |
| This plasma protein maintains volume intravascularly. | Albumin |
| What is the job of globulins? | Globulins prevent and modify infections |
| Name the four blood types: | A,B,AB,O |
| Universal blood donor | Type O- |
| Universal blood recipient | Type AB |
| Where is the spleen located? | LUQ |
| Lymphedema | Accumulation of lymphatic fluid from impaired lymph circulation |
| Assessment findings for lymphedema: | swelling, tight skin, weeping/oozing, firm, shiny, brawny (orange) |
| How is lymphedema treated? | Symptomatic, elevation, compression sleeves/stockings, complex decongestive physiotherapy |
| Lymphangitis | inflamed lymph vessels |
| Lymphadenitis | inflamed lymph nodes |
| How are lymphangitis and lymphadenitis treated? | Broad spectrum antibiotics |
| Assessment Findings of lymphangitis/lymphadenitis: | red streaks, fever, tender/enlarged lymph nodes |
| How do sx of mono last? | 2-6 weeks |
| What is the most common sign of mono? | fatigue |
| TorF: Mono is best treated with bed rest. | True, Bed rest is the best thing for mono, along with analgesics and antipyretics. |
| How is mono transmitted?? | direct contact with saliva |
| When the epstein-barr virus causes mutations in some lymphocytes creating malignant reed-sternberg cells, what is this indicative of? | Hodgkin's Disease |
| S/sx of Hodgkin's disease: | weight loss, anorexia, fatigue, weakness, low grade fever, pruritis, and night sweats |
| How is Hodgkin's treated? | localized radiation and antibiotic therapy for secondary infections |
| The most common form of lymphoma. | Non-Hodgkin's lymphoma |
| indolent non-hodgkin's lymphoma | asymptomatic at diagnosis |
| agressive non-hodgkin's lymphoma | acute symptoms |
| A sudden loss of large volume or a chronic loss of small amounts of blood is ___________ anemia. | Hypovolemic |
| How is IM iron given? | z track |
| Iron-deficiency anemia is most common in | teenage girls |
| expected hgb range for pt with sickle cell anemia | 7-10 |
| What are some environmental causes of of hemolytic anemia? | lead, arsenic, malaria |
Created by:
AmandaSwopes
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