NUR 141 EXAM 2
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| LPNs care for persons who are... | well, ill but stable, injured, convalescent, handicapped
🗑
|
||||
| LPNs work under... | own license and supervision, can not delegate tasks to unlicensed personnel
🗑
|
||||
| most facilities LPN does not... | start IVs, give IVP or IBPB meds, work with central lines, take verbal orders
🗑
|
||||
| LPN duties | caths, dressings, tube feedings, wound irrigation, med adm (not IV), pre-post mortom care
🗑
|
||||
| LPNs can direct, assign and supervise aides in extended care facilities |
🗑
|
||||
| PT does | motor
🗑
|
||||
| OT does | upper extremities and ADLs
🗑
|
||||
| ST does | swallowing, speaking
🗑
|
||||
| "study learning principles" |
🗑
|
||||
| domains of learning | cognitive, affective, psychomotor
🗑
|
||||
| cognitive | intellectual-understanding of risks and s/s of low blood sugar
🗑
|
||||
| affective | emotions, attitudes, values= values blood sugar control and health promotion
🗑
|
||||
| psychomotor | acquiring skills-can use glucometer to check blood sugar level
🗑
|
||||
| pain is the physical sensation, suffering is the emotional response to pain |
🗑
|
||||
| pain lasting > 3 months | chronic, vs can b normal
🗑
|
||||
| sudden pain | acute, inc in BP and vs
🗑
|
||||
| nocioceptive pain | caused by damage to tissue, heals quicker
🗑
|
||||
| nocioceptive somatic pain | superficial (sharp, burning, prickly), deep (aching, throbbing)
🗑
|
||||
| nocioceptive visceral | internal organs (referred pain) cramping, pressure
🗑
|
||||
| nocioceptive pain responds to | opioid and non opioid meds
🗑
|
||||
| neuropathic pain | caused by damage to nerves or CNS (numbing, burning, stabbing)
🗑
|
||||
| causes for neuropathic pain | trauma, inflam, metabolic disease, ETOH, inf. Not well controlled by opioids alone.
🗑
|
||||
| incident pain | is ambulation, change in posiiton
🗑
|
||||
| pattern of pain | onset, duration, breakthrough pain
🗑
|
||||
| non opioids | for mild/mod pain, nonsalicylate, salicylate, NSAIDS
🗑
|
||||
| nonsalicylate | acetminophen-analgesic, antipyretic, hepatic toxicity
🗑
|
||||
| salicylate | ASA-analgesic, antipyretic, antiplatelet, antinflamm
🗑
|
||||
| NSAIDS | losts of side effects
🗑
|
||||
| characteristics of nonopioids | analgesic ceiling, no tolerance/dependence to, OTC, opioid sparing
🗑
|
||||
| opioids | bind to CNS receptors for mod/severe pain, no ceiling
🗑
|
||||
| opioids to avoid | propoxyphene (seizures), meperedine (neurotoxicity)
🗑
|
||||
| side effects of opioids | contstipation, N/V, sedation, resp depression, itching, urinary retention, confusion
🗑
|
||||
| adjuvants for opioids | corticosteroids, antidepressants, antizeizure, GABA receptor agonists, alpha adrnergic agonists, local anesthetics, cannabinoids
🗑
|
||||
| corticosteroids | dec edema/inflam. SE=dose/duration dependent
🗑
|
||||
| antidepressants | inhibit reuptake of serotonin &/or norepinepherine higher levels in synapse. inhibits pain impulses. good for neuropathic pain
🗑
|
||||
| antiseizure | affect peripheral nerves &CNS, good for neuropathic pain, gabapentin (neurotin), pregabalin (Lyrica)
🗑
|
||||
| GABA receptor agonists | muscle spasms
🗑
|
||||
| marrinol | pot in pill form
🗑
|
||||
| a chart of conversion for other meds that do same thing | equianalgesic dosing
🗑
|
||||
| PCA pumps are a high risk for resp depression |
🗑
|
||||
| Tolerance | chronic exposure dec effect of drug. rotate
🗑
|
||||
| physical dependence | expected, experience withdrawl s/s when blood level drops. Taper off.
🗑
|
||||
| addiction | powerful drive to take substance for reasons other than the therapeutic purpose. Seeking SE instead of therapeutic effects
🗑
|
||||
| cancer pain | acute/chronic, r/t desease/tx,
🗑
|
||||
| palliative care | focus on pain control in incurable conditions
🗑
|
||||
| hospice | end of life care, focus on comfort/quality of life vs quantity
🗑
|
||||
| ethical concern with hospice | hasten death
🗑
|
||||
| nutrition in >50 yo | women=1920, men=2300, need more vit D, B12, protien, fat, CHO, fluids
🗑
|
||||
| dehydration in tne elderly | purposely avoid fluids, loose sense of thirst, forget to drink, can get fluids on their own
🗑
|
||||
| lack of nutrition in elderly | poor fitting teeth, taste/swallowing impaired, vision, constipation
🗑
|
||||
| white patches in mouth | leukoplakia
🗑
|
||||
| red velvety patches | erythroplackia
🗑
|
||||
| precursor to esphageal cancer | pharynxesphogitis from reflux
🗑
|
||||
| cancer that is mastatic at time of dx | esophageal cancer, to brain, lungs; removal of esophagus, stints, survial<20%,
🗑
|
||||
| after removal of esophagus | NG tube (do not touch), I/O, VS, pain, mobility, DB, cough
🗑
|
||||
| sign of fever, severe pain and NG contents change after esophagus removal | a leak
🗑
|
||||
| pts with inc temp after surgery | ateloactisis=DB and cough
🗑
|
||||
| gall stone blocking duct can cause | pancreantitis
🗑
|
||||
| lab the is relased with injury | LDL
🗑
|
||||
| lab the inc w other organ dmage | AST
🗑
|
||||
| lab that is liver specific | ALT
🗑
|
||||
| all fluids of body have billirubin except | CSF
🗑
|
||||
| hep A & E | trans w fecal oral
🗑
|
||||
| hep B | trans w body fluid, blood
🗑
|
||||
| hep C | trans blood
🗑
|
||||
| hep D | only have w B
🗑
|
||||
| drug of choice for liver disease | aldactone
🗑
|
||||
| what are some contributing causes for cirrhosis of liver | ETOH, hep C 7 B, chronic inflam, billary cirosis, obstructions
🗑
|
||||
| what labs are for cirrhosis of liver | ALT, LDH, bilirubin, albumin, amonia, PT
🗑
|
||||
| assessment data for cirrhosis liver | pain, fatique, brusing, acetises, LOC, what have been exposed to
🗑
|
||||
| what orders with sirrhosisi of liver | daily st, liver biopsy, parancitisis,, vit K, folic acid, thymiane, DTs, diuretics
🗑
|
||||
| wat liver does | stores carbs, protein, 1st pass, responsible for clotting factors, detoxes at 1st pass
🗑
|
||||
| must have PT prior to liver biopsy | want good clotting: after biopsy ly on R side
🗑
|
||||
| break down of protein | = amonia
🗑
|
||||
| jaundice | bilirubin is x3, clay stools, tea urine, skin itches, anorexic, fatique
🗑
|
||||
| ETOH need | thyamine and folic acid
🗑
|
||||
| common hepatotoxins | isoniazid, acetaminophen, thiazides, tetracycline, methotrexate, ETOH, poisons, heavy metals
🗑
|
||||
| pt adm w RUQ pain N/V, sudden onset, ate shell fis. wat tests dr order | hepatits profile (hep A)
🗑
|
||||
| how is HBV trans | blood, body fluid
🗑
|
||||
| how is HCV trans | blood (transfission, neeedles)_
🗑
|
||||
| how protect yourself from transmission | hep B vac
🗑
|
||||
| hep B more than C can cause | liver cancer
🗑
|
||||
| causes of pancreatitis | obstruction, EToh, gall stones, billiary tract disease
🗑
|
||||
| assessment data for pancreatitis | pain, N/V, fever, HTN, vs, left upper gastric pain
🗑
|
||||
| lab teszts for pancreatitis | amalyse, lipase, BG
🗑
|
||||
| gall stone blocking duct can cause | pancreantitis
🗑
|
||||
| lab the is relased with injury | LDL
🗑
|
||||
| lab the inc w other organ dmage | AST
🗑
|
||||
| lab that is liver specific | ALT
🗑
|
||||
| all fluids of body have billirubin except | CSF
🗑
|
||||
| hep A & E | trans w fecal oral
🗑
|
||||
| hep B | trans w body fluid, blood
🗑
|
||||
| hep C | trans blood
🗑
|
||||
| hep D | only have w B
🗑
|
||||
| drug of choice for liver disease | aldactone
🗑
|
||||
| what are some contributing causes for cirrhosis of liver | ETOH, hep C 7 B, chronic inflam, billary cirosis, obstructions
🗑
|
||||
| what labs are for cirrhosis of liver | ALT, LDH, bilirubin, albumin, amonia, PT
🗑
|
||||
| assessment data for cirrhosis liver | pain, fatique, brusing, acetises, LOC, what have been exposed to
🗑
|
||||
| what orders with sirrhosisi of liver | daily st, liver biopsy, parancitisis,, vit K, folic acid, thymiane, DTs, diuretics
🗑
|
||||
| wat liver does | stores carbs, protein, 1st pass, responsible for clotting factors, detoxes at 1st pass
🗑
|
||||
| must have PT prior to liver biopsy | want good clotting: after biopsy ly on R side
🗑
|
||||
| break down of protein | = amonia
🗑
|
||||
| jaundice | bilirubin is x3, clay stools, tea urine, skin itches, anorexic, fatique
🗑
|
||||
| ETOH need | thyamine and folic acid
🗑
|
||||
| common hepatotoxins | isoniazid, acetaminophen, thiazides, tetracycline, methotrexate, ETOH, poisons, heavy metals
🗑
|
||||
| pt adm w RUQ pain N/V, sudden onset, ate shell fis. wat tests dr order | hepatits profile (hep A)
🗑
|
||||
| how is HBV trans | blood, body fluid
🗑
|
||||
| how is HCV trans | blood (transfission, neeedles)_
🗑
|
||||
| how protect yourself from transmission | hep B vac
🗑
|
||||
| hep B more than C can cause | liver cancer
🗑
|
||||
| causes of pancreatitis | obstruction, EToh, gall stones, billiary tract disease
🗑
|
||||
| assessment data for pancreatitis | pain, N/V, fever, HTN, vs, left upper gastric pain
🗑
|
||||
| lab teszts for pancreatitis | amalyse, lipase, BG
🗑
|
||||
| what DO for pancreatitis | morphine, dilaudid, NPO, NG tube, previcid, Zofran
🗑
|
||||
| pancreas | endo/exocrine secretes insulin, glucagon, digestive enzymes
🗑
|
||||
| pancreatitis tx | NPO (cant excrete lipase,amalace until gone), NGT, morphine, fluid, low fat, bland, pancreatic enzymes, cant drink again or will b back in hosp
🗑
|
||||
| tests for a DM pt | DM diet, insulin, fluids, A1c
🗑
|
||||
| pts on beta blockers are tachy |
🗑
|
||||
| repeated hypoglycemia causes memory loss |
🗑
|
||||
| diabetic ketoacidosis only occurs in | type 1
🗑
|
||||
| somogyi effect | caused by too much insulin, tto much insulin at night
🗑
|
||||
| dawn phenomenon | hypergycemia d/t coungterregulatory hormones, hormone imbalance
🗑
|
||||
| DM and renal failure go together |
🗑
|
||||
| DM causes dec in motility | give Regalan 1/2 hr before meals to inc motility
🗑
|
||||
| A1C | 4-6 non diabetic
🗑
|
||||
| if hypoglycemic give.. | no candy bars (too much fat, delays absorption)
🗑
|
||||
| if hypoglycemic give... | 15-20gm x15min, 6 oj, 4 cola, 8 milk, 3 glucose pills, 5 lifesavers, 1 dry toast, 1/2 c ice cream
🗑
|
||||
| what drug you cant give with a dye study | metforman
🗑
|
||||
| medulla adrenal gland (sympathetic NS) | epinephrine, norepinephrine
🗑
|
||||
| Cortex adrenal gland | mineralcorticoids, glucocorticoids, androgens,
🗑
|
||||
| too many mineralcorticoids, glucocorticoids, androgens = | cushings-pituitary (inc cortisol)
🗑
|
||||
| too little mineralcorticoids, glucocorticoids, androgens = | addisons-adrenal (dec cortisol)
🗑
|
||||
| cushings syndrome is caused from | too much steroids (prenidone) brusing, muscle waste, fatty, poor wound healing, moon face, moods up/down, anmenorea, impotent, gynomastia
🗑
|
||||
| side effects of steroid therapy | osteoparosis, fat to belly, cataracts, moon face, muscle atrophy, DM. diet dec Na, inc Ca
🗑
|
||||
| goup of disorders caused by impared DNA synthesis | Megaloblastic Anemia
🗑
|
||||
| Megaloblastic anemia causes | defective RBC maturation, large RBCs, the RBC have fragile cell membranes which are easily destroyed
🗑
|
||||
| Instrinsic factor is secreated by | gastric mucosa
🗑
|
||||
| Need IF to absorb | cobalamin (B12)
🗑
|
||||
| Absence of intrinsic factor | pernicious anemia-onset after 40yo, large RBCs, dec B12 levels, SERUM FOLATE IS NORMAL,
🗑
|
||||
| parietal cell function test with radioactive cobalamin adm | shillings test
🗑
|
||||
| Upper GI and biopsy of gastric mucosa test for pernicious anemia can cause | inc risk of gastric cancer
🗑
|
||||
| assessment finding for pernicious anemia | sore tongue (red, beefy/shiny), N/V, abd pain, weakness,
🗑
|
||||
| drug therapy for pernicious anemia | dietary B12 doesnt work...use parenteral, intranasal, sublingual.
🗑
|
||||
| increased production of RBCs and impaired circulation dt inc blood viscosity | Polycythemia
🗑
|
||||
| chronic chromosomal mutation with inc RBCs, WBCs and platelets | Polycythemia Vera
🗑
|
||||
| Hoypozia driven, inc O2 demand | secondary polycythemia
🗑
|
||||
| ns assessment for polycythemia | Plethora (ruddy complexion), intermittent claudication (pain in butt, back of legs at rest)
🗑
|
||||
| managemnt of primary polycythemia vera | phlebotomy, monitor i/o, RBC, WBC, platelets, active/passive leg exercises, amb when ordered.
🗑
|
||||
| amb would not be ordered due to | clots
🗑
|
||||
| managment of secondary polycythemia | control chronic pulmonary disease, no smoking, high altitudes
🗑
|
||||
| prehypertension | SBP 120-139, DBP 80-89
🗑
|
||||
| HTN inc risks for | MI, hear failure, stroke, renal disease, silent killer, unknown cause
🗑
|
||||
| target organ diseases for HTN | heart, brain, pere\ipheral vascular disease, kidney, eyes
🗑
|
||||
| HTN heart disease | CAD, L ventricular hypertrophy, heart failure
🗑
|
||||
| HTN cerebrovascular disease | stroke, 4 times more likely to have one
🗑
|
||||
| HTN peripheral vascular disease | speeds up atherosclerosis in peripheral blood vessels
🗑
|
||||
| atherosclerosis can lead to | PVD, aortic aneurysm, aortic dissection intermittent claudication
🗑
|
||||
| death of nephrons from narrowing of the arteries and arterioles | nephrosclerosis, leading cause of ESRD
🗑
|
||||
| labs for nephrosclerosis | albumin, proteinuria, hematuria, elevated BUN and creatinine
🗑
|
||||
| s/s HTN | fatigue, reduced activity tolerance, dizziness, palpitations, angina dyspnea
🗑
|
||||
| ns mangement of HTN | inc fiber, dec fat, inc water, dec salt, dec wt
🗑
|
||||
| fall in bp when a person stands | orthostatic hypotension
🗑
|
||||
| 3 factors of orthostatic hypotension | cardiac func, vascular status, intravascular blood and fluid volumes
🗑
|
||||
| orthostatic vs | bp from lying to sitting to standing q 2 min. SBP inc by 20, DBP inc by 10 and HR inc by 20
🗑
|
||||
| 2 main actions of antihypertensives | dec CO or reduce systemic vascular resistance (the squeeze of vessels
🗑
|
||||
| pts on thiazide should eat foods rch in | potassium
🗑
|
||||
| pt taking thiazides should avoid what OTC | NSAIDs-dec diuretic effects
🗑
|
||||
| monitor what for loop and K+ sparing diuretics | orthostatic hpyotension, hypokalemia, i/o, wt
🗑
|
||||
| pt taking aldoctone (aldosterone receptor blockers) should not eat | fruit w potassium
🗑
|
||||
| avoid what with catapres (adrenergic inhibitors) | any sedative
🗑
|
||||
| pt on lopressor (beta blocker) requires monitoring of | BP and P
🗑
|
||||
| pt on Apresoline (direct vasodilators)and urine is brown and 1+ edema on ankle what going on | rapidly progressing glomerilonephritis
🗑
|
||||
| side effect of Vasotec (ACE inhibitor) | dry hacking cough, in the lungs causes cough. angioedema
🗑
|
||||
| swelling of face and tongue | angioedema, allergic reaction from ACE-inhibitors
🗑
|
||||
| pt on Cozzar (angiotension II receptor blocker) still has high BP | med takes days to weeks to work
🗑
|
||||
| elevated BP w a specific cause that can b identifies and corrected | secondary HTN
🗑
|
||||
| causes of secondary HTN | MAO inhibitors w tyramine foods (wine, cheese, cured meats), estrogen replacement therapy, the pill, NSAIDS
🗑
|
||||
| clinical finding of secondary HTN | hypokalemia, abd buit, variable BPs w tacy, sweating, tremors, fam hx of renal disease
🗑
|
||||
| CAD | fatty deposits on aterial wall that cause inflam "hrdening of the arteries"
🗑
|
||||
| dec risk for CAD | diet, lifestyle, exercise, no smoking, no ETOH
🗑
|
||||
| causes of CAD | cholesterol>240, SBP>160, >1 pack a day smoker
🗑
|
||||
| CAD med that causes Rhabdomyolosis | statins
🗑
|
||||
| rhabdomyolosis | breakdown of skeletal muscle, products get caught in kidneys and cause renal failure
🗑
|
||||
| common side effects of niacin | itching, hot flashes
🗑
|
||||
| fibric acid derivative increase the effects of | coumadin
🗑
|
||||
| bile acid sequestrants interfere with absorption of | digozin, thiazide diuretics, warfarin, penicillins
🗑
|
||||
| cholesterol absorption inhibitors should not be use with what condition | liver impairment
🗑
|
||||
| natural lipid lowering agents | niacin, garlic, omega-3 fatty, psyllium, soy, phytosterols (nuts, seeds), red yeast rice
🗑
|
||||
| leading cause of death | CAD
🗑
|
||||
| chest pain | angina pectoris-caused by dec supply of oxygen to heart muscle
🗑
|
||||
| noncardiac factors that dec O2 to myocardial cells | anemia, asthma, COPD
🗑
|
||||
| noncardiac factors that inc O2 demand of myocardial cells | anxiety
🗑
|
||||
| cardiac factos that dec O2 to myocardial cells | coronary attery spasm, thrombosis, dysrhymias, heart failure
🗑
|
||||
| cardiac factors that inc O2 demand of myocardial cells | aortic stenosis, cardiomyopathy, tachy
🗑
|
||||
| type of Angina | Chronic Stable Angina-secondary to CAD, tx w rest and nitrate
🗑
|
||||
| type of angina | Prinzmetals angina-occurs at rest due to coronary artery spasm. tx w Ca Channel blockers
🗑
|
||||
| Chronic stable angina | pain at rest in neck, jaw, shoulders, arms, between shoulders lasts 5-15min.
🗑
|
||||
| manifestations of CAD tend to occur during | early morning after wakening
🗑
|
||||
| questions for chest pain | Precipitating evens, Quality of pain, Radiation of pain, Severity of pain, Timing
🗑
|
||||
| tx for chronic stable angina | Antiplatelet/anticoagulant, ACE, antiotension receptor blocker; B-adreergic blocker (BP); Cigarette smoling, calcium channel blockers, cholesterol; Diet, DM; Exercise, education; Flu vacc
🗑
|
||||
| unstable angina | at rest, worsening pattern,
🗑
|
||||
| nitro | pain should be relieved in 3 min and last for 30-60min. can give another 5 mins apart x3.
🗑
|
||||
| nitro can cause | dec BP and HA due to vasodilation
🗑
|
||||
| teaching of nitro | accessible at all times, keep in dark bottle, replace q 6 mths, under tongue, feel tingle, no ED drugs, change positions slowly, HA
🗑
|
||||
| sustained ischemia causing myocardial death | Myocardial infarction (MI) by thrombus, pain not relieved
🗑
|
||||
| cardiac disorder that impairs the ability of the ventricle to fill with or eject blood | Heart failure
🗑
|
||||
| why HF instead of CHF | not all pts have volume overload at the time of intial or subsequent evaluations
🗑
|
||||
| s/s HF | ventricular dysfunction, reduced exercise tolerance, diminished quality of life, shortened life expectancy
🗑
|
||||
| most common reason for hospitalization adm in adults >65yo | HF
🗑
|
||||
| two most common causes of L sided failure | systolic failure, distolic failure
🗑
|
||||
| systolic failure | most common, L ventricle fails to contract/pump dec ejection fraction ends up w pulmonary congestion. listen to lungs
🗑
|
||||
| diastolic failure | ventricls stiffen, dec filling, selling feet, some lung congestion
🗑
|
||||
| sign of L sided heart failure | no urinary output
🗑
|
||||
| right sided failure | R ventricle fails pump enough blood to meet body needs, ventricle cant accept all the blood returning to the heart.
🗑
|
||||
| s/s of R sided failure | backs up into veins/capillaries, edema, dry lungs, generalized edema
🗑
|
||||
| Heart failure assessment | Fatigue, Activities limited, Chest congestion/cough, Edema, SOB
🗑
|
||||
| Heart failure assessment | dec blood flow to extremities less hair, chest pain, dusky cool skin, edema, tachycardia, SOB
🗑
|
||||
| s/s R sided HF | Jugular vien distention, pedal edema, wt gain, fatigue, dependent bilat edema, URQ pain
🗑
|
||||
| s/s L sided HF | crackles, changes in mental status, confusion, restlessness, weak, dyspnea, shallow resp, SOB in recumbant, cry hacking cough, nocturia
🗑
|
||||
| 1+ edema | mild pitting, slight indentation, no perceptible swelling of the leg
🗑
|
||||
| 2+ edema | moderate pitting, indentation subsides rapidly
🗑
|
||||
| 3+ edema | deep pitting, indentation remains for a short time, leg looks swollen
🗑
|
||||
| 4+ edema | very deep pitting, indentation last a long time, leg is very swollen
🗑
|
||||
| digoxin (Lanoxin) | dec and strengthens heart beat, check apical HR (>60) prior to adm
🗑
|
||||
| digoxin toxicity | yellow vision, halos. anecdote=digibindIV
🗑
|
||||
| tx for heart failure | diuretics (K+ waisting loops) watch electorlytes (K+, Na), morphine for pain causes vasodilation of lungs to inc capacity
🗑
|
||||
| major cause of PAD | athrerosclerosis
🗑
|
||||
| drug for intermittent claudication | trental, pletal
🗑
|
||||
| tx for PAD | Trental, Pletal, walking, inspect feet, exercise till discomfort than rest start again
🗑
|
||||
| surg tx for PAD | percutaneous transluminal ballon angioplasty, atherectomy (remove plaque), peripheral artery bypass w graft, endarterectomy (remove plaqe from artery), amputation
🗑
|
||||
| thrombosis and fibrosis occur inside the vessel causing exchemia | Buerger's Disease
🗑
|
||||
| Buerger's Disease | obstruction of small arteries, loss of phlanges, stop smoking
🗑
|
||||
| episodic vasospastic disorder fo small cutaneous arteries of fingers and toes | Raynaud's phenomenon, 15-20 yo women.
🗑
|
||||
| second leading cause of cancer in women | breast cancer, 1st is lung
🗑
|
||||
| increased exposure to estrogen causes | breast cancer
🗑
|
||||
| breast cancer tumors are | hard, circular, dimpling, immovable, non tender, large
🗑
|
||||
| risk for endometrial cancer | having 1 or more 1st relative w oravrian cancer, too much extrogen
🗑
|
||||
| beta blockers cause | ED
🗑
|
||||
| S/S prostate cancer | painless enlargement, heaviness, dragging sensatoin
🗑
|
||||
| most dangerous rooms for elderly | kitchen, bathroom, bedroom
🗑
|
||||
| medication risks | absorption, distribution, biotransformation, excretion
🗑
|
||||
| medication errors | polyphrmacy, living alone, inadequate education, inadequate finances, medication regime understanding. 60% take meds wrong
🗑
|
||||
| drug toxicity | earliest sign.. mental confusion
🗑
|
||||
| 4 types of extrapyramidal reactions. Early onset.... | acute dystonia (severe spasm), Parkinsonism (mask face, drooling, tremors, shuffling, stoop, pill rolling), Akethisia (pacing, squirming)
🗑
|
||||
| late onset | tardive dyskinesia (tongue, face, swallowing dec) not reversiable
🗑
|
||||
| insulin reaction | speech disorder, slurring, confusion, disorientation. elderly w beta blockers have hpyoglycemic unawareness
🗑
|
||||
| fluid filled sac that cushions a jt. can become inflamed | bursa-bursitis
🗑
|
||||
| attaches muscle to bone | tendon-tendonitis is from overuse
🗑
|
||||
| inflammation of muscle | myositis
🗑
|
||||
| RICE | rest, ice, compression, elevation. Ice no more than 20min
🗑
|
||||
| tx for swelling and effusion | aspiration and rice
🗑
|
||||
| infection in bone | osteomyelitis by staff aureus
🗑
|
||||
| most common osteomyelitis | indirect via blood stream from elsewhere in body
🗑
|
||||
| direct osteomyelitis | contamination from surgical site, fx, DM foot ucler
🗑
|
||||
| bone deterioration | osteoporosis-deficit in bone replacement
🗑
|
||||
| ostoporosis | bone density test, post menopausal, kyphosis, fx, pain, Ca+vitD, no salt, caffeine, WB exercise, fosomax, evista
🗑
|
||||
| rehabilitation begins | the first day
🗑
|
||||
| loss of motor function | paralysis
🗑
|
||||
| lesser degree of paralysis | paresis
🗑
|
||||
| paralysis-legs lower body | paraplegic
🗑
|
||||
| paralysis all 4 limbs | tetraplegic
🗑
|
||||
| brain thru spinal cord | upper motor neuron
🗑
|
||||
| spinal cord to muscle | lower motor neuron
🗑
|
||||
| sensory impulse to corn, motor neuron, muscle or gland | motor reflex arc
🗑
|
||||
| sacral reflex arcs intact | sacral sparing
🗑
|
||||
| proprioception | ur understanding where ur limbs are
🗑
|
||||
| cervical injury | C1-2=freq fatal (vent dependant; C3-4 vent dependent, diaphragm weak; C5: if can shrug shoulders, no vent, only diaphragm to breath, no intercostals, has shoulder/elbow func, most common cervical injury
🗑
|
||||
| thoracic/lumbar:paraplegic | T1-6 confined to WC; T6down=parapareiss, WK, braces, they shake; above S2=reflex present for bowel/bladder emptying, S2-4, reflex arc destroyed
🗑
|
||||
| impaired resp-vent C1-4 | frequent pulmonary inf, assisted cough, breathing exercises, possible phrenic nerve stim
🗑
|
||||
| impaired O2 transport:immobility | TEDS to prevent pooling, no IMs below injury, ROM q 8*
🗑
|
||||
| Bladder problems above S2 (UMN)Reflexic | bladder Hypertonic, <150CC capacity, reflex voiding, urgency, frequency, stroke trigger areas
🗑
|
||||
| Badder problems S2-4 Areflexic | reflex destroyed, hypotonic,>500cc residual(cant empty), overflow voiding, crede or St cath
🗑
|
||||
| Bowel problems above S2 (UMN) Reflexic | spastic bowel, dulcolax suppos, digital stim
🗑
|
||||
| Bowel problems S2-4 (LMN) Areflexic | Atonic bowel, enemas, digital removal,
🗑
|
||||
| sexuality | above C5 and up, women use birth control (not pill)
🗑
|
||||
| exaggerated ANS response to stimuli | Autonomic dysreflexia
🗑
|
||||
| autonomic dysreflexia | pt w lesion above T6 (often due to full bladder or bowel)can last 6yrs after injury.
🗑
|
||||
| s/s autonomic dysreflexia | generalized vasoconstriction first then sudden severe HTN. HA, brady, inc BP, dec P
🗑
|
||||
| autonomic dysreflexia can result in | CVA, SAH, seizure and death
🗑
|
||||
| Ns intervention for autonomic dysreflexia | fast action..raise HOB (90*), BP,check for full bladder, bowel, UTI, kinked cath, use anesthetic lubricant for digital stim and cath,
🗑
|
||||
| device that prevents neck flexion | halo traction
🗑
|
||||
| musculo-skeletal changes in the elderly primary | dec muscle mas/strength, jt mobility, shoulder width, disc space mineral loss in bones, fat to belly
🗑
|
||||
| musculo-skeletal changes in the elderly secondary | unsteady gait, osteoporosis, fax, curvature of spine, osteo arthritis
🗑
|
||||
| inflammation of freely moveable jts, bilateral, symmetric, poy-arthritis in all extremities | Rheumatoid arthritis-autoimmune disease, genetic, rheumatoid factor present
🗑
|
||||
| systemic symptoms of RA | fever, wt loss, fatiue, feneralized aching, early morning stiffness, tachy, weakness, anemia
🗑
|
||||
| local s/s of RA | jts stiff, pain, edema, prosimal finger jts enlarged, swan neck deformity, nodules on extensor surfaces
🗑
|
||||
| who are more susceptible for getting RA | Pima and Chipawa tribe women
🗑
|
||||
| meds for RA | DMARDS (Methotrexate #1), NSAIDS, asprin (enteric coated 4-6gm), Anit inflams (Prednisone),
🗑
|
||||
| Ns interventions for RA | pain, inflam, ROM warm H2O therapy, own ADLs, assistive devices, splints for extension not flexion
🗑
|
||||
| removal of synovia, reduces inflam and helps maintain jt func | synovectomy
🗑
|
||||
| jt replace ment | arthroplasty
🗑
|
||||
| cut bone to change alignment or correct deformity | osteotomy
🗑
|
||||
| fusion of jt | arthrodesis
🗑
|
||||
| chronic inflam autoimmune disease (vascular and connective tissue) | systemic lupus erythematosus-multi system disease, reversible form, poly arthritis, red butterfly rash
🗑
|
||||
| what caused lupus | procame
🗑
|
||||
| dx of lupus | +LE cell prep and ANA, Anti-DNA, Anti-Smith (most dx)
🗑
|
||||
| inflam disease of voluntary muscle | polymyositis-degeneration of muscle fibers. tx high dose steroids
🗑
|
||||
| s/s of polymyositis | muscle weakness, difficulty moving/swallowing, symmetrical, includes polyarthritis, arthralgias and Raynauds
🗑
|
||||
| polymyositis with rash, | dermatomyositis-more prone to malignancy with in 5 yrs. tx high dose steroids
🗑
|
||||
| disease that affects jts and surrounding tissue, loss of srticular cartilage in WB jts | osteoarthritis (DJD) from over use
🗑
|
||||
| s/s of DJD | pain, stiffness in jts after rest, crepitation, Bouchard(PIP) and Heberden(DIP)nodes
🗑
|
||||
| tx for DJD | tylenol (4gm),
🗑
|
||||
| metabolic disorder, too much uric acid | gout-no meat, alcohol
🗑
|
||||
| 3 causes of gout | poor renal excretion of uric acid, metabolism of purine, inc in uric acid production,
🗑
|
||||
| s/s of gout | crystals in tissues cause pain (jts/kidneys), red swollen jts,
🗑
|
||||
| swollen red great toe | podagra
🗑
|
||||
| meds for gout | culchasine, fluids, uloric, cozar and zyloprim together
🗑
|
||||
| tx for gout | meds, ice, elevate, uric acid levels, foot craddle
🗑
|
||||
| benign bone tumor | osteoma
🗑
|
||||
| malignant bone tumor | osteosarcoma-young males 10-25yo and fatle, pain swelling in knee
🗑
|
||||
| dx of bone tumors | ALK phos and Ca will be inc, CAT scan, PET, MRI, biopsy
🗑
|
||||
| complications of amputations | hemorrhage, edema, contractures, inf
🗑
|
||||
| care for amputations | no elevations, chair rest x1hr, prone 3-4xdaily, monitor stump for bleeding, body image
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
vstein
Popular Nursing sets