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Nclex II-- Endocrine

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
        Help!  

Question
Answer
List the major symptoms of hyperthyroidism?   show
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What is another name for hyperthyroidism?   show
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show Too much T3 T4-- too much energy  
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show Increase the pulse and BP. When the pulse and BP is increase it increase the workload of the heart.  
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show Iodine  
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Explain how the antithyroid drugs work?   show
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show Propacil, PTU, Tapazol.  
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Why do you have to give Iodine compounds in milk or juice and use a straw.   show
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show Decrease HR/BP, decrease anxiety.  
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show Destroys thyroid cells  
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What is one of the major complications of radioactive iodine?   show
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show Decreases  
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When a patient has been placed on an antithyroid, what do you except to happen to theis thyroid hormone level?   show
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show Decrease vascularity, decrease chance of hemorrhage.  
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When a patient has had a thyroidectomy, why is it so important for them to have neck support.   show
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How do you want a thyroidectomy patient to be position. Explain   show
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Why do we check for bleeding behind the neck with a thyroidectomy patient?   show
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Why do we keep a trach set at the bedside with a thyroidectomy patient?   show
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show Listen for horseness.  
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Why do we assess for parathyroid removal in the thyroidectomy patient?   show
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How do you assess for parathyroid removel?   show
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show Any Signs of hypocalemia.  
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What is another name for hypothyroidism.   show
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show Decrease.  
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show Fatigue, GI slow, increase weight, slow speech, cold.  
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show Hypothyroidism present at birth.  
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show Give thyriod hormones-- synthroid, proloid, cytomel.  
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show Permanent  
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show Hypercalcemia  
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show B/C calcium is being pulled from the bones, put into blood, osteoporosis.  
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show to much calcium in blood.  
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show hypocalcemia  
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What type of symptoms will they exhibits   show
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Why dose the hypoparathyroid patient need a quiet environment?   show
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Why does a hypoparathyroid patient need a trach tray next to the bed.   show
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show Serum phosporus is high already.  
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Explain how amphojel works for the hypoparathyroid patient   show
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show Problem with the adrenal medulla-- benign tumor that secrete norepinephine that maks blood pressure increase and heart rate increase.  
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What happes to thier blood pressure and Pulse. (pheochromcytoma)   show
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What is the major diagonostic test for the pheochromocytoma? Explain?   show
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What is the four major actions of glucocorticoids?   show
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show Aldosterone.  
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How does aldosterone work.   show
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show steroids. adrenocorticotropin hormones (ACTH) cortisol.  
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Why do steroids drive your blood sugar up?   show
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show Blood volume goes up, retaining NA and H2O  
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show Body does not have enough steriods (aldosterone) -- Na and H2O is lost -- K+ is retained (think about shock and hyperkalemia)  
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When you think of Addison's disease, what is the chemical told you to focus on?   show
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show Hyperkalemia  
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What are the S/S of hyperkalemia?   show
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show Yes, too much k+  
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show Not enough  
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show Losing volume, not enough Aldosterone  
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show To retain volume in thier vascular space. (they're losing thre NA.)  
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Why is I & O such an important nursing intervention with the Addison's disease patient?   show
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Is the Addison's disease patient in a fluid volume deficit of fluid volume excess?   show
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show Decrease  
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show Moon face, buffalo hump, women with male traits, FVE, skinny arms / legs, large abdomen.  
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When a patient has cushing's syndrome, do they have too many steroids or not enough.   show
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Why does the cushing syndrome patient experiene the following? Growth arrest, Increase risk of infection, Hyperglycmia, Psychosist, Depression....   show
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show Excess.  
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Why does the cushing's syndrome patient develop high blood pressure.   show
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show Because they are in FVE.  
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show Because they have to much aldesterone. (retain to much NA and H2O and lose k+  
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Why does the cushing' syndrome pateint need more calcium in thier diet.   show
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Why does the cushing's syndrome patient have ketones in their urine and glucose in their urine.   show
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show Low, NA makes you retain h2o. this patient doesnt need more fuild retention b/c they are already in excess.  
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Why does the cushing's syndrome patient not have protein in their urine? Is it normal to have Protein in the urine.   show
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In a diabetic patient, what is absent that makes their blood sugar go up?   show
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show Carries Glucose out of the vascular space to the cell. Decrease the blood sugar.  
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show Because their is no insulin  
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In the diabetic patient, why does their body start breaking down protein and fat.   show
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show Ketones.  
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show Acid  
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What is the major acid base imbalance the diabetic patient can develop and explain why?   show
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why does the diabetic deveop the following syptoms. A Polyuria B. WT loss C Polydypsia D. Polyphagia   show
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show They stimulant the pancreas to make insulin. Micronase, Diabeta, glucotrol  
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Why will an oral hypoglycemia agent not work in a type 1 diabetics.   show
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Why does TYPE II diabetic have problems with wounds that will not heal or repeated vaginal infections?   show
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show Diet and exercise Oral Agents Insulin  
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In treatment of a diabetic, why do we have to limit the protein in their diet.   show
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show There is a lot of glucose in the system and it deposits just like fat. (arteriosclerosis occurs)  
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How can a highfiber diet benefit a diabetic patient?   show
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When the diabetic patient exercises, why do they have to worry about hypoglycemia and how can hey prevent it.   show
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show To prevent hypoglycemia.  
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show Decrease.  
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show B/C insulin should lower BS. Therefore there shouldnt be any excess to spill into the urine. Also insulin should prevent fat being broken down.  
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If you are giving somebody insulin and they do have glucose and ketones in their urine, what needs to be done to the dose of the insulin.   show
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Why do we draw up regula insulin first.   show
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show CLear / Regular.  
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show Rapid~~~ 2-4 hours. Intermediate (NPH)7-12 or 8-12 Long Acting (protamine Zinc) 18+ or 16-18  
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When insuli is at its Peak, that means the insulin is working really hard; therefore what is going to happen to the blood sugar at the peak time?   show
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When patient have given themselves insulin, they need to know when insulin peaks B/C what is the major complication of the peak time.   show
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show Inform patient to eat, take regular insulin, and eat healthy snacks.  
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Why is it so important that the injection sites the diabetic uses be rotated.   show
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What is going to happen toanybody's blood sugar when they are sick or stressed.   show
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show Increase.  
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show DKA  
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Do we aspirate insulin? Why?   show
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show Shaking, weak, decrease LOC, cool clammy skin, nervousness, Increase pulse, nausea, sweating, HA..... Simple Sugar.  
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After a patient has experienced hypoglycemia and they have drank a coke or eaten some candy or whatever, what do they need to do next? Explain Why?   show
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show Brain can die  
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Are D50W and injectable glucagon temporary or premanent increase in the blood sugar.   show
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If you walk into a diabetics patient's room and they are unconscious, do you treat the patient like they are hypo or hyper.   show
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YOu give an unconscious patient an amp of D50W B/C you think they are HYPO. The patient should start to wake up. When they are awake, what should you get tem to do.   show
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show To prevent HYPO, and keep their BS within Normal range.  
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Why does the diabetic patient sometimes develop Kussmaul's respirations?   show
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show Not enough insulin-- blood suger increases- polyuria, polydypsia, polypahgia-- fat breakdown (acidosis) -- Kussmauls resp.  
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When a patient has diabetic ketoacidosis, why is it so important that we measure the blood sugar and the potassium hourly?   show
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show Decrease- insulin drops the blood sugar.  
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When you give someone insulin, what do you except it to do to theirserum potassium level. Explain why   show
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Why is it so important that we montior the diabetic ketoacidotice patient's EKG so Closely.   show
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Why are we measuring hourly output on the diabetic ketoacidosis patient.   show
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When you get a diabetic ketoacidosis patient into the hospital, they may have polyuria, anuria or oliguria. Please Explain, in the proper sequence, why the patient starts with polyuria, then converts to oliguria and anuria.   show
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show Kidney failure-- B/C the kidneys aren't perfused properly.  
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When a DKA patient presents to the emergency room, are they in a fluid volume deficit or a fluid volume excess? Explain Why?   show
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show Patient is in fluid volume deficit.  
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How does normal saline work?   show
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What could the patients blood sugar be with DKA   show
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When you get the DKA patient into the emergency room, you are going to see the doctor order IV push insulin, therefore, what is going to start happening to the blood sugar rapidly?   show
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show To prevent throwing the patient into hypovolemic state.  
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show By decreasing the blood sugar rapidly with insulin.  
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Diabetic patient have problems with their vascular system, Why? Give examples.   show
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show Clip nail straight across, be careful with lotion, inspect feet each day, dry inbetween toes very well, wear leather shoes all the time.  
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show The amount of blood being pumped out of the LV  
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show NO  
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If you are taking care of a patient with decrease cardiac output, what is going to happen to their level of consciousness.   show
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show Yes  
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show Because there is no perfusion. (perpheral vasoconstriction in an effort to shunt blood to vital organs)  
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show The heart is not pumping the fluid out of the body, so it backs up to the lungs.  
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show Because the heart is not pumping out to the periphery  
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show Decrease, No pressure.  
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show Becuase the heart is not pumping out as much volume. Less volume= less pressure.  
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How will bradycardia affect cardiac output?   show
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show Decrease ventricles cant fill up; dont have time to fill b/c heart is beating to fast.  
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When someone has had an MI, how can this affect cardiac output and why?   show
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If my blood pressure is really high, how will this affect cardiac output and why.   show
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What is preload.   show
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If you increase preload, what do you do to the workload of the heart.   show
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show Trendelenburg position, hyervolemia, supine, evelate legs  
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List some ways preload can be decrease.   show
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Expain afterload in your own words.   show
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If you increase afterload, what do you do to cardiac output.   show
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if cardiac output is decrease, that means the blood is not moving forward. If the blood isnt moving forward, then it has got to go backwards, so therefore where is it going to wind up?   show
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show Decreased blood flow to the myocardium--> ischemia  
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show Blood flow decreases (decreased O2) and causes chest pain (pressure sensation)  
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show to relieve the pain-- vasodilates which increase blood/ O2 to heart.  
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When you give somebody nitroglycerine, more ___________ is going to get to the heart.   show
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show 1 every 5 min. X 15 mins (max 3 doses)  
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show Some nitroglycerine burns and that is normal  
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show Headache  
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When you give somebody nitroglycerine, are they going to vasconstrict of vasodilate? therefore what is going to happen to their blood pressure?   show
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show They decrease workload of the heart and decrease contractilly; decrease blood pressure. Inderal--lopressor.  
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show Decrease blood pressure, decrease workload of heart. Verapamil, Calon, Procardia. These drugs also dilate CA which enhances blood flow to the heart.  
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show Balloon to open coronary arteries to enhance blood flow__ MI  
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show Because overwork the heart.  
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show to decrease the work load of the heart.  
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show Yes.  
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Before they take their nitroglycerine, should the patient sit down or stand up? Explain?   show
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With a MI, why does the patient have necrosis?   show
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show NO  
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show Severe, non-stop pain; chest pressure; radiation to the left arm and jaw.  
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show Decrease CO (dead tissue doesn't pump well.)  
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Why does the MI patient's white count go up?   show
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Why does their temperature go up?   show
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Explain Cardiac enzymes and include: A why do we have to draw the isoezymes? B. Tell me the time frame for which these peack (CPK LDH)C. Troponin   show
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show Nitroglycerin  
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When a pateint in having an MI, whta arrhythmia are they at very high risk for?   show
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show D-fib  
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What drug is sometimes started IV on a MI patient to prevent things like PVC or V tach or V fib?   show
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show TOXICITY  
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If a MI patient performs the valsalva, which nerve can be stimulate   show
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If you stimulate the Vagus nerve long enough, what is going to hjappen to the heart rate?   show
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What happens to the size of the complex when the vagus nerve is stimulated.   show
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When a patient goes into a thuird-degree block, what are the major drugs that are used.   show
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How fo thrombolytics work? Give me three examples of common Thrombolytics.   show
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show Hemorrhage.  
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Before you give a thrombolytic, you are supposed to get a good history. What did I tell you to focus on (what type diseases or Illnesses)   show
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After someone has received a thrombolytic, why is it so important that we decrease puncture sites.   show
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show Because contrast dye is used and it contain iodine.  
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show Warm/flushing/ sweating  
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When a patient has a heart cath, they will have a puncture site. Where might that puncture site be?   show
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show Bleeding and hematoma.  
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show Assess circulation. Pulse, Skin temp, cap refills, skin color  
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show SA node.  
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Can electrical part of your heart be working and the mechanical not.   show
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show Demand- kicks in only when the patient needs it to Fixed-- fires at a fixed rate constantly  
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You really need to get worried about a pacemaker malfunctioning when the rate of the pacemaker does what?   show
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Why is it so important that we immobilize the arm on the affected side after pace maker insertion?   show
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show Make sure the pace maker is staying in range.  
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Why does the pacemaker patient have to avoid microwave and MRI?   show
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show Dyspnea, cough, pulonary congestion, blood tinged sputum, restlessness, tachycardia; blood backs up into lungs.  
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show Because they become hypoxic  
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show When they lie down more blood can go back into there heart and lungs.  
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show Blood is backing up into the lungs.  
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show CHF  
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What are the major symptoms of right sided failure.   show
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show Venous  
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What does a Swan Ganz cath measure inside the heart   show
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show Any pressure reading on the right side of the heart. More volume= More pressure.  
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What is the wedge pressure?   show
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show PRessure in left side of heart.  
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If a patient's wedge pressure is increasing, that means volume is building up in the left side of the heart. when volume is building up in the left side of the heart, that puts the patient at risk for developing what?   show
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show Arterial line-- in artery-- measures cont BP on a monitor.  
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What is an Allen's test?   show
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Why is it so important that the distal circulation be checked when a patient has an A-line? Explain your checks that you are going to do (nursing assessment)   show
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if an A-line is accidently pulled out, what is the first thing that needs to be done.   show
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When a patient has an A-line, pressure has to be kept on the infusion bag. why? what would happen if you didnt keep pressure on the infusion bag?   show
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Why does the patient in heart failure develop cardiomegaly?   show
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show slows down the heart rate which give the ventricles more time to fill with blood. then the heart can squeese down with the stronger contraction on more blood; therfore is increase cardiac output.  
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show Fill with blood.  
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show CO increase. Kidney Increase.  
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Anytime you increase kidney perfusion, what is going to happen to urine output?   show
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When you start giving a patient Digoxin, should their cardiac output fo up or down.   show
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When you increase a patient cardiac output, what is actullay happening inside the heart.   show
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When you increase a patient cardiac output, should they appear better oxygenated or less oxygenated.   show
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When you start giving somebody Dig, we expect their card output to increase; therefore, what happen to their. LOC, lung sounds, uring output, skin, peripheral pulse, BP.   show
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Why does a CHF patient need Lasix.   show
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show Diuresis may occur  
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show So the patient will not be up all night.  
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show To monitor themselves for Fuild retention.  
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If a CHF patient notices thier WT increasing, what could that put them at risk for?   show
🗑
show The sudden onset of fluid accumulation in the lungs leading to severe hypoxia.  
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show The left ventricle is failing so the blood is not being pumped forward into the systemic circulation; therefore, the blood backs up into the lungs.  
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What are the major S/S of pulmonary edema?   show
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show at night- because lying down preload icreases so we are dumping more blood into the right side of the heart and into the lungs.  
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Why is the patient in pulmonary edema, restlessness, and anxious.   show
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show Becuase they cant handle the volume of blood in there lungs.  
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show Given to strenthen the contraction more and increase cardiac output.  
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show Aminophylline is a bronchodilator given to help the patient breath better.  
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What are some of the common side effects of Aminophylline?   show
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When a patient is in pulmonary edema, why do we give them morphine.   show
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How much morphine do we give them?   show
🗑
show To decrease venous return  
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What is one quick check you can do on patients to see if they are going into pulmonary edema?   show
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When you are taking care of a patient who is at risk for pulmonary edema, why do we use 10 inch blocks?   show
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Why are the elderly, the very young, MI patient or kidney patients at risk for going into fluid volume overload or pulmonary edema?   show
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show The pain that develops as a result of inadequate oxygenation in an extremity associated with arterial problems  
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show When oxygenated blood cannot get to an area, the patient is going to switch in that extremity from aerobic metabolism to anaerobic metabolism. the product of anaerobic metabolism is a buildup of lactic acit. the lactic acid is what promotes the pain.  
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When a patient has as arterial problems, that means the oxygen/blood are having a hard time getting to the tissue, so therefore different S/S develop. Explain ?   show
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show Yes-- B/C oxygenatated blood is not getting to an area.  
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show will restore oxygenated blood flow to an area. (opens up the artery)  
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Whether you are studying buerger's or raynaud's, what is the key word that I told you to remember.   show
🗑
show Emotional upset, smoking, coldness.  
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show Buerger- excellent foot care- avoid cause. Raynards- avoid cause.  
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show Cause  
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show Foot care is appropriate with any perpheral vascular.  
🗑
show NO  
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show Phlebitis, thrombophlebitis, DVT  
🗑
show Elevate  
🗑
show The blood can get to the area. the problem is once it gets there it cannot get away. so you get stagnation of blood flow in one area.  
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show To decrease the chance of a new clot forming and to keep the present clot from getting bigger.  
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show They enhance venous return, decrease pooling  
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show Warm moist heat to decrease imflammation  
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What is a thoracentesis?   show
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When a patient is having a thoracentesis, where is the fluid being removed from.   show
🗑
show It is the potential space between the visceral and parietal pleural  
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show Collapse  
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Any time you are pulling fluid from the patient body (thoracentesis, paracentesis, foley cath) you are pulling the patient at risk for going into fluid volume deficit or fluid volume excess.   show
🗑
There is a possiblity with a thoracentesis that a pneumothorax could occur. why?   show
🗑
What has happened when a patient needs a chest tube?   show
🗑
show Promote one-way flow of air. Broken outside air can go into pleural space. To let air that comes out of the pleural space escape from the bottle.  
🗑
show A good connection  
🗑
When a patient has a chest tubes, hopefully the lung should do what?   show
🗑
show Hook it back up unless you happen to have a sterile connector in the room. Then you would use the brand new sterile connector  
🗑
What would happen if the water seal in the chest system is broken?   show
🗑
If a break in the chest system occurs, air from the outside can rush into the pleural space and cause what life threatening complication.   show
🗑
What is the first thing the nurse should do if the chest tube is accidnetly dislodged from the patient.   show
🗑
How can dehydration promote an embolus?   show
🗑
show B/C a thrombus can from and dislodge and go to the lungs.  
🗑
show Bith control pills make your blood get thick.  
🗑
When a patient has a pulmonary embolus, why does their pulse go up.   show
🗑
show Sharp, stabbing  
🗑
show It will increase the work load of the right side of the heart.  
🗑
show inflammation  
🗑
Why does the PO2 go down with a pulmonary embolus?   show
🗑
What type of line will be put into the patient to monitor the right side of the heart.   show
🗑
How will heparin help the patient who has developed a pulmonary embolus?   show
🗑
show Blood in the pleural space.  
🗑
show Air in the pleural space.  
🗑
show Collapse  
🗑
What should you do if a patient presents with a penetrating object to the chest.   show
🗑
show The pressure has accumulated in the pleural apce and has collasped the lungs and pushed everything to the opposite side.  
🗑
With a mediastinal shift, what will happen to the trachea.   show
🗑
When a patient has an open pneumothorax, you are supposed to put a piece of petroleum gause over the are. How many sides are taped down? Why do we leave one side open.   show
🗑
When a patient has a fractured sternum or ribs, why are the respirations so shallow? what acid base imbalance will this put them at risk for?   show
🗑
With a fractured sternum or ribs, why do we give non-narcotic analgesics.   show
🗑
With a fractured sternum or ribs, why is the patient put on a ventilator with PEEP?   show
🗑
What is PEEP?   show
🗑
What is CPAP   show
🗑
show PEEp exerts pressure at the end of exhalation and CPAP is pressure throughout the breathing cycle.  
🗑
What is flail chest.   show
🗑
What is paradoxical chest wall movement?   show
🗑
show Because of the broken ribs.  
🗑
What is the definition of cardiac tamponade?   show
🗑
show Blood pressure goes down because of hemorhaging. CVP goes up b/c as the sac fills around the heart, this puts pressure on the heart, squeezing the heart. Therefore the pressure inside the heart goes up making CVP go up  
🗑
Why do the heart sounds sound muffled with cardiac tamponade.   show
🗑
With cardia tamponade, why does a patient go into shock.   show
🗑
show Mycobacterium Tuberculosis  
🗑
show Ultraviolet light  
🗑
Explain the skin test for TB?   show
🗑
show It means the patient has been exposed.  
🗑
show Peripheral neuritis Vitamin B  
🗑
When a patient is on INH, what lab work has to be monitored.   show
🗑
When a patient is on INH, what should be eliminated from their diet.   show
🗑
What are the major side effect of Rifampin.   show
🗑
show Liver enzymes  
🗑
When a patient is on streptomycin, what are two possible side effects.   show
🗑
How would you monitor for these side effects.   show
🗑
show Streptococcus  
🗑
show Fluid volume Excess  
🗑
show Build up of toxins.  
🗑
show Because the kidneys are failing  
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show They are unable to excrete the urea and creat throught the kidneys.  
🗑
show B/C the glomerulus has holes in it, so protein can leak out.  
🗑
Explain CVA tenderness.   show
🗑
show Retaining fluids.  
🗑
And what will happen to the urine specific gravity?   show
🗑
In glomerulonephritis, why are the patient's red blood cells affected?   show
🗑
show Because protein makes your urea level in your blood go up.  
🗑
If you gave a patient with any type of renal disease protein in their diet, what will happen to the BUN?   show
🗑
Why does the glomerulonephritis patient need bed rest.   show
🗑
show To account for the insensible fluid loss.  
🗑
Once diuresis begins in glomerulonephitis, will the patient be at risk for a fluid volume deficit or fluid volume excess.   show
🗑
show All will be increased, due to the kidneys not being able to excrete  
🗑
When a patient had nephorotic syndrome, what is the major element that is leaking out into their urine?   show
🗑
show Fluid  
🗑
show Goes out into the interstitial space tissue.  
🗑
How does this affect the vascular space.   show
🗑
show FVD  
🗑
show Anasarca  
🗑
When a patient has nephrotic syndrome, it is not uncommon for them to be placed on prednisone. WHy?   show
🗑
show Low sodium diet is needed to decrease futher edema  
🗑
show High protein diet to help offset the amount of protein is losing through their glomerulus  
🗑
show Decrease perfusion  
🗑
How can hypovolemia cause reanl failure.   show
🗑
How can shock cause renal failure   show
🗑
show Decrease perfusion  
🗑
show Vascular damage.  
🗑
How can the kidney stone cause renal failure   show
🗑
show urine can be trapped in the kidney  
🗑
How can a tumor or an enlarged prostate cause renal failure.   show
🗑
show B/C the patient is unable to excrete urea and the creatinine.  
🗑
show It usually goes up, but it can also become fixed. when is becomes fixed this means that the patient's urine specific gravity doe nto respond to high volumes of fluids or restriction of fluids. It stays the same.  
🗑
Why can a renal failure patient become anemic?   show
🗑
show B/C they are retaining fluids.  
🗑
show B/C they are retaining fluids.  
🗑
Why does the renal failure patient develop anorexia, Nausea and Vomiting?   show
🗑
Why does the renal failure patient develop an itching frost?   show
🗑
Why does a renal failure patinet have to worry about osteoporosis?   show
🗑
show Urine output has decrease.  
🗑
show Retaining fluids.  
🗑
show unable to excrete potassium  
🗑
show Increase  
🗑
Why will a patient who is diuresing go into a fuild volume deficit?   show
🗑
If a patient goes into a fluid volume deficit, what will happen to theis blood pressure.   show
🗑
show Increase- trying to compensate for the decrease in volume  
🗑
When a patient is diuresing, their serum potassium level goes doen (hypokalemia) Explain Why   show
🗑
if a patient is allergia to Heparin, they cannot be hemodialyzed.   show
🗑
show no  
🗑
show Yes, B/C between treatments the ptient is unable to excrete excess electrolytes and fluids.  
🗑
show No BP , no punctures in that extremity, do not wear a watch on that extermity, check it for adequate crculation  
🗑
Explain in your own words what peritoneal dialysis is?   show
🗑
show Abdomen- peritoneal cavity.  
🗑
show Turn the patient from side to side or reposition.  
🗑
Wha should the drainging of peritoneal dialysis look like.   show
🗑
What are the S/S of infections with the peritoneal dialysis.   show
🗑
When a patient has capd for their renal failure, why do they have to increase protein and fiber in their diet.   show
🗑
When a patient has CAPD, why do they have a constant sweet taste and why do they have anorexia.   show
🗑
What are the major signs of kidney stones.   show
🗑
Wha is the number one thing you need to remember with kidney stones.   show
🗑
show Discard the first voiding, keep all urine for the next 24 hours in a specal sontainer and save the last void.  
🗑
show 24 hour urine.  
🗑
show not usually- it is just an xray.  
🗑
When a patient has an IVP (intravenos Pyelgram), exactly wht is this x-ray looking at?   show
🗑
Does an IVP use dye? if so, what had you better ask the pt if they are allergic to?   show
🗑
show Urethra and bladder.  
🗑
Wht is the normal pre-procedue activities for a cytoscopy.   show
🗑
show Watch for urine retention, burning in common for a couple of days due to urethra irritation, and blood tinged urine is okay for a day or so.  
🗑
Why is the serum creatinine not affected by what we eat?   show
🗑
show Blood  
🗑
Is the BUN affected by wht we eat?   show
🗑
show B/C they cannot handle the volume of blood. They hav to have packed red blood cells.  
🗑
show B/C the will aggregate together.  
🗑
Why do we give albumin or dextran in shock? Howd these work?   show
🗑
What should yo do if your patinet begins o have a transfusion reations.   show
🗑
show 30 mins.  
🗑
How long do you have to get it infused.   show
🗑
Explain themajor symptoms of febrile or septic blood transfusion reaction.   show
🗑
show Symptoms -- flushing, itching, urticaria, hives. TX; Benadryl  
🗑
show Back pain is number one, Chills, fever, flusing, increase pusle,increase RR, BP decrease.  
🗑
show Incopatible blood. Stop the blood, start the saline, get a urine specimen, save the blood, call the dr, call he bld bank, get vitalsigns and prepare to flush out the kidneys with mannitol.  
🗑
show To flush out the kidneys.  
🗑
show Urine  
🗑
show Te shape of the red blood cell is changing doe to hypoxia.  
🗑
Are patinet who have sickle cell hypoxic   show
🗑
show Due to the shape, they start hanging together.  
🗑
show B/C their red blood cells sickle. so their red blood count decrase.  
🗑
show Jaundice develope when th overabundance of sickle cells ae fragile and rapidly destroyed in circulation releasing the bilirubin.  
🗑
show since the patient is hypoxic they stay tachy most of the time; therefore, this stresses the heart.  
🗑
show little clot can form and cut offcircultain to an area.  
🗑
show B/C the cell can cut off circulation to an area.  
🗑
show To help them make red blood cells.  
🗑
What types of things will bring on a crisis in the sickle cell patient? Explain Why   show
🗑
show Hydration in No 1, oxygen will be needed, blood tranfusions will be neeed, bedrest and decrease pain.  
🗑
show Infection.  
🗑
What is anemia?   show
🗑
When you do not have enoug red blood cells, the patient will be hypoxic. Why?   show
🗑
show Losing red blood cells.  
🗑
show no formingred blood cell.  
🗑
show With out erthropoietin, immature RBC cannot mature.  
🗑
show B/C they are hypoxic  
🗑
show B/C they're hypoxic  
🗑
When a patinet is anemic, why do they have a plae conjunctiva?   show
🗑
Why do anemic patint develop heart problems.   show
🗑
show hypoxia  
🗑
show Organ meat, egg yolk, seafood, legumes, green leafy, dried fruits, almonds  
🗑
What can be given with iron to increase the absorption?   show
🗑
What is some major side effect of iron (ferrous sulfate)   show
🗑
show Stain  
🗑
What does Iron do to he stool.   show
🗑
show We want to trap the injection fluid deep into the muscle. We do not want it leaking out of thetissue- it can stain the skin.  
🗑
show B-12  
🗑
Afte wha surery can a patient develop pernicious anemia?   show
🗑
show Red swallow tongue and neuro changes.  
🗑
What is the major dianostic test for pernicious anemia.   show
🗑
Will the schilling's test tell you about any othe type of anemia beside pernicious anemia?   show
🗑
Whyare IM injections of b-12 effective wit pernicious anemia. why does oral b-12 not work in thi patient.   show
🗑
show Large amounts of immature WBC.  
🗑
When a patient has leukemia, they are at high risk for infection. Why.   show
🗑
show B/C there are so many immature WBC, there's no room for RBC.  
🗑
Why does the leukemic patient develop thrombocytopenia?   show
🗑
show B/C they dont have enoug platlets; therefore they will bleed int he muscle.  
🗑
show You wont want to give anythin to them that woul promote moe bleeding.  
🗑
show Bed rest is needed due to decreased RBC (hypoxia) and also to prevent trauma.  
🗑
show to replace RBC- to fight anemia.  
🗑
show to replace RBC- to fight anemia  
🗑
Why does the leukemia pt develop weakness and fatigue?   show
🗑
WHy does the leukemia patiet have S/S such as bleeding, bruises, or petechiae.   show
🗑
Hemophilia is an inherited disease. Does it affect males or females?   show
🗑
show Females.  
🗑
show Large spreading bruises. May blee into the joit or into the muscle of the G tract.  
🗑
When a patient is having bleeding into the joints, what is teprope term for this?   show
🗑
show They dont need anything that is ging to increase their bleeding episodes.  
🗑
Why is dental hygiene so important with a hemophiliac.   show
🗑
What are somethings yu would teach a hemophiliac in regard a day to day living?   show
🗑
show Toprevent furthur trauma.  
🗑
What tye of emboli do yu worry about with a fractue.   show
🗑
show Cover it with somethin sterile.  
🗑
Explain Neuro checks?   show
🗑
show A. movement and sensatin. B. Vascular- cap refills, skin temp, color pulse  
🗑
Give S/S of a fat embolus?   show
🗑
What is compartment syndrome?   show
🗑
show Loosen the cast.  
🗑
show We dont want to indent the cast.  
🗑
Cast care: no indentation   show
🗑
Cast care: Use the palm for the first 24 hours.   show
🗑
show To allow heat to escape.  
🗑
Cast care: Dont rest cast on hard surface or sharp edge.   show
🗑
Cast care: Cover cast close to thegroin with plastic.   show
🗑
show Elevate to decrease edema  
🗑
show Neurovascular check  
🗑
What are some of the purpose of traction?   show
🗑
show If the Wts are not hanging freely then th amount of traction bein applied is not what the dr has ordered.  
🗑
show the skin has not been penetrated. bucks traction and russell traction are examples.  
🗑
show Skin, because the skin is being pulled on.  
🗑
show Prolonged traction using pins and wires. Steinmann Pinns or a Halo vest.  
🗑
show Use sterile tech; remove the crust.  
🗑
show A. Internal rotation or external rotatin cold dislocate. B. dislocate the hip C. extension minidislocation d. Keeps the balls of the hips in the socket.  
🗑
show Assess the degree of flexion the machine is exerting ; assess the patient pain level and tolerance of the machine.  
🗑
What are some good exercises for the total hip replacement patient?   show
🗑
Why is it so important that the total hip replacement patient avoid flexion?   show
🗑
show Bending over, sitting in a low chair climbing stairs.  
🗑
Why is it important that we keep a tourniquet at the bedside with amputation?   show
🗑
show To decrease edema and bleeding?  
🗑
show Extend the joint-- prone position is a good position to extend the hip and knee.  
🗑
show Pain that is experrienced in the amputated extremity. the pain is real.  
🗑
show Diversional activity and pain meds are given.  
🗑
show Swollen joints, fatigued, increase WBC, reddened fingers dur inflammatio, morning stiffness. (lasting longer then 30 mins) and a low grade temp.  
🗑
show Increase  
🗑
show Females  
🗑
List the S/S separately and explain why the patient develops each symptom.   show
🗑
show To decrease inflammation.  
🗑
Why is it so important that the rheumatoid arthritis patient's joint stay in proper position?   show
🗑
Why is rheumatoid arthritis pt placed on Chemotherpy?   show
🗑
show To decrease the stress on weight -bearing joints, particularly the knees.  
🗑
What is the difference in rheumatoid arthritis and osteoartritis?   show
🗑
show Lose wt, non-steroidal, steroids and rest.  
🗑
What is gout?   show
🗑
What are S/S of gout?   show
🗑
Wha are the three major drugs used for gout? Explain how they work?   show
🗑
What diet change chould thegout pateint make.   show
🗑
Why is it soimportant tha the gut patient drinks lots of fluids,decrease alcohol, and avoid becoming dehydrated?   show
🗑
show LOC  
🗑
What is the pulse pressure?   show
🗑
show It widens  
🗑
I a neuro patiet complains of a headache, what would this man.   show
🗑
Explain the doll's eye reflex.   show
🗑
show When ice water instille into he ear canal by the physician to assess brain stem function. Normal response would be to look towards the painful stimuli.  
🗑
show When the bottom of te foot is stroked yo and you watch to see what the toes are going to do. in child less that 1 yr a positive Babinski is ok. + toes fan out, over 1 we want toes to curl in.  
🗑
show No  
🗑
Can a CT scan be done with conrast medium (dye)   show
🗑
show Yes.  
🗑
What type of patient cannot tolerate an MRI scan.   show
🗑
Explain everything that you would teach a patinet about an MRI.   show
🗑
What is cerebral angiography?   show
🗑
When a ptient is having cerebral angiography, what artey do hey go through.   show
🗑
show Heart cath.  
🗑
Why is it so important tht a patient who is about to have cerebral angiography be well hydrated.   show
🗑
show Post-procedure we will be needing to check the circulation in the extremity tomake sure clots didnt form distal to the punture sight. so baseline data should be collected pre-procedure.  
🗑
show the dye causes a flushed feeling.  
🗑
It is important that you ask this patient who is about to have cerebral angiography if they are allegic to something. What is it.   show
🗑
show Same as heart cath. Check peripheral circulation, keep extremity still. Clot formation, decrease movement to decrease hemorrhage chances.  
🗑
show B/C clots could form and go to the brain. WEre lookingfor change in LO and any motor or sensory deficits and one sided weakness or paralysis.  
🗑
What is a myelogram?   show
🗑
When a patient has a myelogram, are we getting into the cerebrospinal fluid?   show
🗑
show Patient will be NPO and have a light sensative.  
🗑
Why is it so imporant in myelogram patient that we increase the fluids.   show
🗑
What are some gereral symptoms of meningitis.   show
🗑
show B/C the meninges have been punctured into, so an infection cold have been introduced.  
🗑
What is an EEG   show
🗑
What is the preprocedure care for a patient who is going to have an EEG   show
🗑
If a patient were about to have an EEG, what would you tell them about the procedure.   show
🗑
When a patient shaving a lumbar puncture, do we get into cerebrospinal fluid.   show
🗑
show to check for lood, to measure pressure and to obtain a specimen.  
🗑
How do you positin a patient for a lumbar punctur?   show
🗑
Why doyou put athem in this position?   show
🗑
show Clear and colorless.  
🗑
show We want the patient to be on bed rest, lying flat so a seal can form at the puncture sight. patient should drink many fluids. we should check the dressing to make sure it is not wet.  
🗑
show Headache.  
🗑
How is this complicatin treated.   show
🗑
What is the fatal complication of a lumber puncture.   show
🗑
show Pt loses consciousness, then wakes up afte going through a recovery period. butthen the bleeding in the head increase, the pt starts having neuro changes and they possibly will pass ot again.  
🗑
show Stop the bleeding; control the ICP  
🗑
When a patient has a subdural hematoma, explain the sequence of event that can occur. (s/s)   show
🗑
show Fight infectons.  
🗑
What is n open head injury.   show
🗑
What is a close injury?   show
🗑
WIth which fracture is thepatient most at risk forinfection?   show
🗑
show Bleeding in the eyes, ears, nose, and throat.  
🗑
When a patient has a basal skull fracture. Where isthe fracture.   show
🗑
What is battle sign.   show
🗑
show Bruises around the eyes.  
🗑
What is cerebrospinal rhinorrhea.   show
🗑
Explain the S/S of a concussion.   show
🗑
show be aware of S/S such as difficulty awakening or speaking confusion severe headaches, vomitting, pulse chages, unequal pupils or one sided weakness.  
🗑
show no.  
🗑
What a trauma ptient comes into the emergency roo, why do we have to assume a C-spine injury is present.   show
🗑
show to protect the cerical spine and spinal cord.  
🗑
show it will test positive for glucose and form a halo on a sheet or pillowcase.  
🗑
show to decrease the stimuli which could initiate seizures.  
🗑
When yo have a head injured patient, why do we have to pad the side rails?   show
🗑
show B/C we dont want to maskneuro checks.  
🗑
show When the patient sits up, ICP goes down, when they lie down, ICP goes up.  
🗑
What is posturing?   show
🗑
Explain the two different types of postering.   show
🗑
When a patient is posturing, what happens to their caloric needs.   show
🗑
Why are osmotic diuretice used in the treatment of ICP? Explain exactly how they work.   show
🗑
When a patient is on an osmotic diuretic,they better have teo organs that are working perfectly. What are they?   show
🗑
show Potential for fluid volume deficit.  
🗑
show to decrease cerebral edema.  
🗑
How can hypeventilation decrease ICP.   show
🗑
What would happen to the ICP if te temp were to exceed 100.4   show
🗑
show Everytime you do something to a hed injured patient, ICP goes up  
🗑
show to decrease cerebral metabolism there fore decreaseing ICP  
🗑
show too many fluds will increase ICP  
🗑
What should you restrict the fluids to? (how many CC per day)   show
🗑
Why do we avoid restraints, bowel and bladder distension, hip flexion, valsalva, isometrics, suctioning and coughing in te head injured patiet.   show
🗑
show Decrease B/C not as much blood would be pumping,pe out by the LV; therefore not as much blood would make it to he brain.  
🗑
If te patient develop an increase blood pressue, what will happen to cardiac output? Explain how this would affect cerebral perfusion?   show
🗑
show Infections.  
🗑
Why is it so important ta we keep the connections tight on an ICP monitoring device and also why is it so important to keep the dressing dry?   show
🗑
Wha is Myasthenia gravis.   show
🗑
When a patient has impulse problems, what is going to happen to their moscle tone.   show
🗑
Explain the s/s og myasthenia and explain why the patient develops these symptoms.   show
🗑
Tensilon is used to help diagnose myasthenia gravis. explain what will e done.   show
🗑
show These drugs increase acetylcholine concentration at the myoneural junctions to facilitate transmission of impulses across the nerves therefore increasing muscle tone.  
🗑
show Myasthenia is thought to be an autoimmune problem, therefore steroids are given t decrase the immune reasponse.  
🗑
show B/C the patint may notbe able to swallow.  
🗑
show B/C the resp muscle could become affected.  
🗑
If a patient with myasthenia gets too tired or takes an over the counter medicine, what cold happen.   show
🗑
Wht is the difference in temyasthenia crisis and a cholinergi crisis? How do you differentiate them?   show
🗑
When a patient is in a crisis with Myasthenia,why would you prepare them for a ventilator?   show
🗑
What is the pre-procedure care for a patient who is going to have an upper GI.   show
🗑
Yo are taking care of a patient who is going t have an upper GI. Explain what is going to happen to the ptient.   show
🗑
YOur patient is goingto have a barium enema. what is he preprocedure care?   show
🗑
Hw would you describe a barium enema to a patient   show
🗑
show B/C we dont want the bariu to stay in the body.  
🗑
What is the preprocedure care of a gastroscopy? Explain to your patint to except if they are going t have a gastroscopy.   show
🗑
show B/C we dont wantthem to aspirate.  
🗑
Wha would be a major sign of perforation post gasteoscopy?   show
🗑
You patient is going to have a liver biopsy. What clotting studies should be checked? Please explain why?   show
🗑
show We are worried about hemorrhage.  
🗑
How is a patient positioned during a liver biopsy.   show
🗑
Ho is a patint post liver biopsy? Explain Why   show
🗑
Why dos the patient have to exhale and hold while the physician is puncturing into te liver.   show
🗑
show Removal of fluid from the peritoneal cavity  
🗑
show Sit them up.  
🗑
Why is it important that the paracentesis patient void pre-procedue.   show
🗑
show Because you are worried about throwing the patinet into a FVD  
🗑
During a paracentesis, the patient could be thrown into a FD or FVE   show
🗑
show Enocrine- Insulin; Exocrine- digestive enzymes.  
🗑
What is a major cause of pancreatitis?   show
🗑
How can gallbladder disease cause pancreatitis   show
🗑
show A large pancreas  
🗑
show Possible hemorrhage.  
🗑
Pancreatitis: Jaundice   show
🗑
show Inflammation  
🗑
show Bleeding or ascites.  
🗑
Pancratitis: Serum lipase and amylase (up or Down) WBC, Blood sugar, SGOT, SGPT   show
🗑
show Polonged.  
🗑
Pancreatitis: Serum bilirubin (u or D)   show
🗑
Pancreatitis: H/H (up or down)   show
🗑
Why do we give the pancreatitis patient steroids.   show
🗑
show TO dry secretions  
🗑
show to decrease acid in the stomach.  
🗑
Is it possible that a pancrestitis patient might have to have insulin? Explain Why?   show
🗑
show Because, the ascites could be pressing up on the diaphragm.  
🗑
show In lavage, you instill fluid into the abdomen and then drain it back into if it comes back pink tinged. it helps ID internal bleeding.  
🗑
What is the major eletrolyte imbalance a pancreatitis patient can get into? explain?   show
🗑
show Clear liq, increase food slowly, no stimulating foods. freq small meals, high carbohydrates for energy  
🗑
Wht is cirrhosis?   show
🗑
When a patient has cirrhosis, what happens to the bloodpressure oin their live and wat is the proper term for this.,   show
🗑
show Firm, nodular liver. abdomnal pain, chronica dyspepsia. Changes in bowel habit, ascites.  
🗑
show A build up of ammonia.  
🗑
Why are we worried abut I and O and daily wts wit the cirrhosis patient?   show
🗑
show To rest the liver.  
🗑
Why are we worried about prevention of bleeding in the cirrhosis patient.   show
🗑
show Measuring to see how much fluid is accumlating in their abdomen. Incidates Vacular volume is going down.  
🗑
Where is the first place a cirrhosis patient might develop jaundice.   show
🗑
show Alteration in skin integrity.  
🗑
Why do you have to avoid narcotics in any liver problem.   show
🗑
show Decrease.  
🗑
Why does the liver patinet need a low-sodium diet.   show
🗑
show Ammonia.  
🗑
show B/C the liver is unable to convert ammonia to urea.  
🗑
What are symptoms of hepatic coma? Explain why the patient develops these symptoms.   show
🗑
show Neomucin and Lactualose b/c they decrease Ammonia.  
🗑
show Increase b/c the liver cannot convert ammonia to urea.  
🗑
What are bleeding esphageal varices.   show
🗑
Why does a patient develop bleeding esophageal varies?   show
🗑
Why is oxygen important with a patient who has bleeding esophageal varices.   show
🗑
Explain how Vasopressin works.   show
🗑
What is one of the complications of giving vasopressin?   show
🗑
What is another name for vasopressin   show
🗑
Why does the patient with bleeding esophageal varices need a Sengstaken Blakemore tube   show
🗑
What is the nursing care associated with a Sengstaken Blakemore tube.   show
🗑
What is the difference in ulcerative colitis and Crohn's Disease.   show
🗑
What are the symptoms of ulcerative colitis and crohns disease?   show
🗑
What is another name for Crohn's   show
🗑
show Low fiber diet b/c a high fiber diet would increase motility  
🗑
Why does the patient with ulcerative colitis or chorn's need to avoid cold foods, and smoking?   show
🗑
show Gantrisin which is a sulfonamide (antibiotic) to decrease infecton and inflammation.  
🗑
Why does the patient with ulceratie colitis of Crohn's diseas need steroids.   show
🗑
Why does the patient with ulcerative colitis or Crohns disease possibly need psychotherapy?   show
🗑
show Thy may do a total colectomy or a Koch's Pouch or they could just remove the part that is damaged are re-hookup eveyhing else.  
🗑
show May remove the entire smallintestines or only the affected area.  
🗑
show Continuous liquid drainage.  
🗑
Why should an ileostomy patient need to avoid rough foods or high fiber foods?   show
🗑
Why does the ileostomy patient need Gatorade.   show
🗑
Why is the ileostomy patient at risk for kidney stones.   show
🗑
show Potassium.  
🗑
Explain the nursing care for a colostomy.   show
🗑
show B/C the appendix fills with bowel conent and becomes inflamed and can rupture.  
🗑
show Right lowe quadrant pain and an elevated WBC; may have some nausea and vomiting and rebound tenderness.  
🗑
Why do we avod giving an enema to a patient twho has appendicitis?   show
🗑
When a patient has had anyabdominal sugery, what is the postion of choice and why?   show
🗑
Explain symptoms of peptic ulcers.   show
🗑
show To decrase acid-- liquid to coat the stomach.  
🗑
Why do we give the patient with peptic ulcer disease H-2 receptorantagonist? List some example.   show
🗑
show To form a barrier over the wound so acid cannot get on the wound.  
🗑
Why is it important that the peptic ulcer patient decrease stress.   show
🗑
show Smoking increase stomach acid.  
🗑
show Eat wht you can tolerate bt avoid extra spicy foods.  
🗑
What is the difference in a pepotic ulce and a duodenal ulcer.   show
🗑
What is dumping syndrome?   show
🗑
show Gastrectomy, Gatic Bypass.  
🗑
What are the symptoms of dumping syndrome   show
🗑
show Lie back when eating the lie flt after meals; drink fluids between meals; do not drink fluids with meals.  
🗑
show Whenpart of the stomach moves up into the thoracic cavity.  
🗑
show Heartburn, regurgitation, difficulty swallowing.  
🗑
What are the major nursing interventions for a patiet who has a hiatal hernia?   show
🗑
show TPN  
🗑
Why does a ptien whois receiving hyperalimentation need a centralline.   show
🗑
show To avoid throwing the patie tinto hypoglycemia. Hyperalimintation solutios are packed with glucose.  
🗑
Why is it so important that we monitor daily WT in the hyperal patient?   show
🗑
show B/C hyperal has such a high glucose load in it they may need additional insulin to maintain the blood sugar within a normal range.  
🗑
show Checking urine fr glucose and ketones.  
🗑
Why is it so important that we not mix hyperal ahead of time.   show
🗑
Why does hyperalimentation need to be on a pump?   show
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Why is it so important that home TPN patient emphasize handwashing?   show
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If you were going to help a doctor insert a central line, what should you do first.   show
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show The patient is placed in trendelenburg positin (to Distend the jugula and subclavian veins.  
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show Jugular vein or subclavian vein.  
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If air gets into your central line, what is going to happen? What position should you place the patient in?   show
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After the central line has been inserted, we always get a chest x-ray. what two things are we checking for in this chest xray?   show
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