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Med Surg II

Ch 17, 30, 31, 32

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