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