Term
| maslows hiriarchy of needs |
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Definition
| physiologic, safety, love and belonging, esteem, and self actualization |
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Term
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Definition
| assesment, diagnosis, planing, implementation, evaluation |
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Definition
• Airway
• Breathing
• Circulation |
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Definition
Males 14-18
• Females 12-16 |
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Definition
Males 42-52
• Females 37-47 |
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Definition
Males 4.7-6.1 million
• Females 4.2-5.4 million |
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Definition
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Definition
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Definition
| 11-12.5 sec (INR and PT TR = 1.5-2 times norma |
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Definition
| 60-70 sec (APTT and PTT TR = 1.5-2.5 times normal) |
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| Prominent U waves, Depressed ST segment, Flat T waves |
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Definition
| Tall T-Waves, Prolonged PR interval, wide QRS |
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Definition
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Definition
| muscle spasms, convulsions, cramps/tetany, + Trousseau’s, + Chvostek’s, prolonged ST interval, prolonged QT segment |
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Definition
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Term
| Glycosylated Hemoglobin (Hgb A1c) |
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Definition
| 4-6% ideal, < 7.5% = OK (120 days) |
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Definition
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Definition
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Definition
| Used for Acidosis vs. Alkalosis |
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Definition
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Definition
| 35-45 (Respiratory driver) … High = Acidosis |
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Definition
| 21-28 (Metabolic driver) … High = Alkalosis |
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Definition
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Definition
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Definition
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Definition
| Vitamin K (Keep PT and INR @ 1-1.5 X normal) |
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Definition
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Term
| antidote Magnesium Sulfate |
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Definition
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Term
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Definition
| Protamine Sulfate (Keep APTT and PTT @ 1.5-2.5 X normal) |
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Term
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Definition
| Mucomist (17 doses + loading dose) |
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Term
| antidote Opiates (narcotic analgesics, heroin, morphine) |
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Definition
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Term
| antidote Cholinergic Meds (Myesthenic Bradycardia) |
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Definition
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Definition
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Definition
• Blood Products (2 RNs must check)
• Clotting Factors
• Sterile dressing changes and procedures
• Assessments that require clinical judgment
• Ultimately responsible for all delegated duties |
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Term
| o Unlicensed Assistive Personnel |
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Definition
| o Unlicensed Assistive Personnel |
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Term
| o Universal (Standard) Precautions … HIV initiated |
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Definition
• Wash hands
• Wear Gloves
• Gowns for splashes
• Masks and Eye Protection for splashes and droplets
• Don’t recap needles
• Mouthpiece or Ambu-bag for resuscitation
• Refrain from giving care if you have skin lesion |
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Term
| o Droplet (Respiratory) Precautions (Wear Mask) |
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Definition
• Sepsis, Scarlet Fever, Strep, Fifth Disease (Parvo B19), Pertussis, Pneumonia, Influenza, Diptheria, Epiglottitis, Rubella, Rubeola, Meningitis, Mycoplasma, Adenovirus, Rhinovirus
• RSV (needs contact precautions too)
• TB … Respiratory Isolation |
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Term
| o Contact Precautions = Universal |
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Definition
Goggles, Mask and Gown
o No infection patients with immunosuppressed patients |
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Term
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Definition
| Rust/orange/red urine and body fluids |
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Term
| Pyridium (for bladder infection) |
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Definition
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Term
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Definition
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Term
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Definition
| Weakness with change in vitals (give more meds) |
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Term
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Definition
| Weakness with no change in vitals (reduce meds) |
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Term
| Diabetic Coma vs. Insulin Shock |
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Definition
| Give glucose first – If no help, give insulin |
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Definition
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Term
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Definition
• If it comes out of your ass, it’s Acidosis.
• Vomiting = Alkalosis |
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Definition
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Definition
| in PMs only – No grapefruit juice |
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Term
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Definition
| Tongue points toward side of lesion (paralysis), Uvula deviates away from the side of lesion (paralysis) |
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Definition
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Term
| after first ACE Inhibitor dose |
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Definition
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Term
| with Ca++ Channel Blockers |
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Definition
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Definition
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Term
| o Pulmonary air embolism prevention |
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Definition
| Trendelenburg (HOB down) + on left side (to trap air in right side of the heart) |
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Term
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Definition
| Maintain airway = primary concern |
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Term
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Definition
| Feed a Duodenal Ulcer (pain relieved by food) |
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Term
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Definition
| Starve, not food relieved |
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Term
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Definition
| Fetal position, Bluish discoloration of flanks (Turner’s Sign), Bluish discoloration of pericumbelical region (Cullen’s Sign), Board like abdomen with guarding … Self digestion of pancreas by trypsin. |
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Definition
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Definition
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Definition
| every 30 minutes … 2 fingers room underneath |
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Term
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Definition
| … Weakness progresses from legs upward – Resp arrest |
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Term
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Definition
| ~30 min before scheduled administration |
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Term
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Definition
| 30-60 min after drug administration |
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Term
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Definition
| after beginning of improvement with increase in energy levels |
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Term
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Definition
Hypertensive Crisis with Tyramine foods
• Nardil, Marplan, Parnate
• Need 2 wk gap from SSRIs and TCAs to admin MAOIs |
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Term
| Lithium Therapeutic Range |
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Definition
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Term
| Phenothiazines (typical antipsychotics) |
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Definition
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Term
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Definition
| work on positive and negative symptoms, less EPS |
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Term
| Benzos (Ativan, Lorazepam, etc) |
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Definition
| good for Alcohol withdrawal and Status Epilepticus |
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Term
| Antabuse for Alcohol deterrence |
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Definition
| Makes you sick with OH intake |
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Term
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Definition
| Delerium Tremens – Tachycardia, tachypnea, anxiety, nausea, shakes, hallucinations, paranoia … (DTs start 12-36 hrs after last drink) |
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Term
| Opiate (Heroin, Morphine, etc.) Withdrawal |
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Definition
| Watery eyes, runny nose, dilated pupils, NVD, cramps |
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Term
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Definition
| Depression, fatigue, anxiety, disturbed sleep |
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Term
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Definition
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Definition
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Definition
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Term
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Definition
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Term
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Definition
| = Decerebrate Posturing (Extended elbows, head arched back) |
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Term
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Definition
| Decorticate Posturing (Flexion of elbows, wrists, fingers, straight legs, mummy position) |
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Term
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Definition
| minimal competency of heart and kidney function |
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Term
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Definition
Cholelithiasis
• Flank pain = stone in kidney or upper ureter
• Abdominal/scrotal pain = stone in mid/lower ureter or bladder |
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Term
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Definition
• Fluid and electrolyte problems … Watch for HyperK+ (dizzy, wk, nausea, cramps, arhythmias)
• Pre-renal Problem = Interference with renal perfusion
• Intra-renal Problem= Damage to renal parenchyma
• Post-renal Problem = Obstruction in UT anywhere from tubules to urethral meatus.
• Usually 3 phases (Oligouric, Diuretic, Recovery)
• Monitor Body Wt and I&Os |
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Term
| Cushing’s Syndrome symptoms) |
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Definition
| Steroid Effects = Moon face, hyperglycemia, acne, hirsutism, buffalo hump, mood swings, weight gain – Spindle shape, osteoporosis, adrenal suppression (delayed growth in kids) |
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Term
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Definition
| medical emergency (vascular collapse, hypoglycemia, tachycardia … Admin IV glucose + corticosteroids) … No PO corticosteroids on empty stomach |
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Term
| Potassium sparing diuretic |
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Definition
| Aldactone (Spironolactone) … Watch for hyperK+ with this and ACE Inhibitors. |
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Term
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Definition
| Troponin (1 hr), CKMB (2-4 hr), Myoglobin (1-4 hr), LDH1 (12-24 hr) |
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Term
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Definition
| Nitro – Yes … NO Digoxin, Betablockers, Atropine |
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Term
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Definition
| Streptokinase, Tenecteplase (TNKase) |
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Term
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Definition
| Coronary Artery Bypass Graft |
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Term
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Definition
| Percutaneous Transluminal Coronary Angioplasty |
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Term
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Definition
| it is ok when able to climb 2 slights of stairs without exertion (Take nitro prophylactically before sex) |
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Term
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Definition
| TURP (Transurethral Resection of Prostate) … some blood for 4 days, and burning for 7 days post-TURP. |
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Term
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Definition
| Only isotonic sterile saline |
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Term
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Definition
| Keep tracheostomy set by the bed with O2, suction and Calcium gluconate |
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Term
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Definition
| … Pericardial Friction Rub, Pain relieved by leaning forward |
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Term
| Post Strep URI Diseases and Conditions: |
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Definition
• Acute Glomerulonephritis
• Rheumatic Fever … Valve Disease
• Scarlet Fever |
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Term
| If a chest-tube becomes disconnected |
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Definition
| do not clamp … Put end in sterile water |
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Term
| Chest Tube drainage system |
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Definition
| hould show bubbling and water level fluctuations (tidaling with breathing) |
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Term
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Definition
| Treatment with multidrug regimen for 9 months … Rifampin reduces effectiveness of OCs and turns pee orange … Isoniazide (INH) increases Dilantin blood levels |
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Term
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Definition
| before steroids for asthma … Exhale completely, Inhale deeply, Hold breath for 10 seconds |
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Term
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Definition
| Make sure alarms are on … Check every 4 hours minimum |
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Term
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Definition
| Pre and Post oxygenate with 100% O2 … No more than 3 passes … No longer than 15 seconds … Suction on withdrawal with rotation |
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Term
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Definition
• Emphysema = Pink Puffer
• Chronic Bronchitis = Blue Bloater (Cyanosis, Rt sided heart failure = bloating/edema) |
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Term
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Definition
• Never more than 6L/min by cannula
• Must humidify with more than 4L/hr
• No more than 2L/min with COPD … (CO2 Narcosis)
• In ascending order of delivery potency: Nasal Cannula, Simple Face Mask, Nonrebreather Mask, Partial Rebreather Mask, Venturi Mask
• Restlessness and Irritability = Early signs of cerebral |
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Term
| IVs and Blood Product Administration |
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Definition
o 18-19 gauge needle for blood with filter in tubing
o Run blood with NS only and within 30 minutes of hanging
o Vitals and Breath Sounds … before, during and after infusion (15 min after start, then 30 min later, then hourly up to 1 hr after)
o Check Blood: Exp Date, clots, color, air bubbles, leaks
o 2 RNs must check order, pt, blood product … Ask Pt about previous transfusion Hx
o Stay with Pt for first 15 minutes … If transfusion rxn … Stop and KVO with NS
o Pre-medicate with Benadryl prn for previous urticaria rxns |
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Term
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Definition
• D5W
• NS (0.9% NaCl)
• Ringers Lactate
• NS only with blood products and Dilantin |
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Term
| Diabetes and Insulino When in doubt |
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Definition
| Treat for Hypoglycemia first |
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Term
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Definition
| NS, then infuse regular insulin IV as Rx’d |
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Term
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Definition
| confusion, HA, irritable, nausea, sweating, tremors, hunger, slurring |
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Term
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Definition
| weakness, syncope, polydipsia, polyuria, blurred vision, fruity breath |
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Term
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Definition
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Term
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Definition
| Regular (Clear) insulin into syringe first when mixing insulins |
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Term
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Definition
| Rotate in 1 region, then move to new region |
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Term
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Definition
| Lispro (Humalog) and Aspart (Novolog) … O: 5-15 min, P: .75-1.5 hrs |
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Term
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Definition
| Regular (human) … O: 30-60 min, P: 2-3 hrs (IV Okay) |
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Term
| Intermediate Acting Insulin |
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Definition
| Isophane Insulin (NPH) … O: 1-2 hrs, P: 6-12 hrs |
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Term
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Definition
| Insulin Glargine (Lantus) … O: 1.1 hr, P: 14-20 hrs (Don’t Mix) |
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Term
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Definition
decrease glucose levels by stimulating insulin production by beta cells of pancreas, increasing insulin sensitivity and decreasing hepatic glucose production
• Glyburide, Metformin (Glucophage), Avandia, Actos
• Acarbose blunts sugar levels after meals |
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Term
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Definition
| Anemia (reduced RBC production), Immunosuppression (neutropenia and immature WBCs), Hemorrhage and bleeding tendencies (thrombocytopenia) |
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Term
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Definition
| most common type, kids, best prognosis |
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Term
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Definition
| Painless lump or swelling testicle … STE in shower > 14 yrs … 15-35 = Age |
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Term
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Definition
… > 40 = Age
• PSA elevation
• DRE
• Mets to spine, hips, legs
• Elevated PAP (prostate acid phosphatase)
• TRUS = Transurethral US
• Post Op … Monitor of hemorrhage and cardiovascular complication |
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Term
| Cervical and Uterine Cancer |
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Definition
• Laser, cryotherapy, radiation, conization, hysterectomy, exenteration … Chemotherapy = No help
• PAP smears should start within 3 years of intercourse or by age 21 |
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Term
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Definition
| leading cause of death from gynecological cancer |
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Term
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Definition
Leading cause of cancer in women
• Upper outer quadrant, left > right
• Monthly SBE
• Mammography … Baseline @ 35, Annually after age 50
• Mets to lymph nodes, then lungs, liver, brain, spine
• Mastectomy … Radical Mastectomy = Lymph nodes too (but no mm resected)
• Avoid BP measurements, injections and venipuncture on surgical side |
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Term
| Anti-emetics given with Chemotherapy Agents |
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Definition
(Cytoxan, Methotrexate, Interferon, etc.)
• Phenergan (Promethazine HCl)
• Compazine (Prochlorperazine)
• Reglan (Metocolpramide)
• Benadryl (Diphenhydramine)
• Zofran (Ondansetron HCl)
• Kytril (Granisetron) |
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Term
| Syphilis (Treponema pallidum) |
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Definition
| Chancre + red painless lesion (Primary Stage, 90 days) ... Secondary Stage (up to 6 mo) = Rash on palms and soles + Flu-like symptoms … Tertiary Stage = Neurologic and Cardiac destruction (10-30 yrs) … Treated with Penicillin G IM. |
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Term
| Gonorrhea (Neisseria Gonorrhea) |
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Definition
| Yellow green urethral discharge (The Clap) |
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Term
| Chlamydia (Chlamydia Trachomatis) |
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Definition
| Mild vaginal discharge or urethritis … Doxycyclin, Tetracycline |
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Term
| Trichomoniasis (Trichomonas Vaginalis) |
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Definition
| Frothy foul-smelling vaginal discharge … Flagyl |
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Term
| Candidiasis (Candida Albicans) |
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Definition
| Yellow, cheesy discharge with itching … Miconazole, Nystatin, Clomitrazole (Gyne-Lotrimin) |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
o Breathing Es taught in advance (before or early in pre-op)
o Remove nail polish (need to see cap refill)
o Pre Op … Meds as ordered, NPO X 8 hrs, Incentive Spirometry & Breathing Es taught in advance, Void, No NSAIDS X 48 hrs
o Increased corticosteroids for surgery (stress) … May need to increase insulin too |
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Term
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Definition
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Term
| Wound dehiscence or extravisation |
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Definition
| Wet sterile NS dressing + Call Dr |
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Term
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Definition
| < 30 mL/hr urine, Sys BP < 90, T > 100 or < 96 |
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Term
| o Post Op Monitoring VS and BS |
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Definition
| … Every 15 minutes the first hour, Every 30 min next 2 hours, Every hour the next 4 hours, then Every 4 hours prn |
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Term
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Definition
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Definition
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Term
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Definition
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Term
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Definition
• THR … No Adduction past midline, No hip flexion past 90 degrees
• Supratentorial Sx … HOB 30-45 degrees (Semi-Fowler)
• Infrantentorial Sx … Flat
• Phlebitis … Supine, elevate involved leg
• Harris Tube … Rt/back/Lt – to advance tube in GI
• Miller Abbott Tube … Right side for GI advancement into small intestine
• Thoracocentesis … Unaffected side, HOB 30-45 degrees
• Enema … Left Sims (flow into sigmoid)
• Liver Biopsy … Right side with pillow/towel against puncture site
• Cataract Sx … Opp side – Semi-Fowler
• Cardiac Catheterization … Flat (HOB no more than 30 degrees), Leg straight 4-6 hrs, bed rest 6-12 hrs
• Burn Autograph … Elevated and Immob 3-7 days
• Amputation … Supine, elevate stump for 48 hrs
• Large Brain Tumor Resection … On non-operative side |
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Term
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Definition
| Inhale slowly and completely to keep flow at 600-900, Hold breath 5 seconds, 10 times per hr |
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Term
| Post Op Breathing Exercises |
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Definition
Every 2 hours
• Sit up straight
• Breath in deeply thru nose and out slowly thru pursed lips
• Hold last breath 3 seconds
• Then cough 3 times (unless abd wound – reinforce/splint if cough)
o Watch for Stridor after any neck/throat Sx … Keep Trach kit at bed side |
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Term
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Definition
| removed in 7-14 days – Keep dry until then |
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Term
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Definition
| No lifting over 10 lbs for 6 weeks (in general) |
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Term
| If chest tube comes disconnected, |
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Definition
| put free end in container of sterile water |
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Term
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Definition
| Valsalvas, or Deep breath and hold |
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Term
| If chest tube drain stops fluctuating |
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Definition
| the lung has re-inflated (or there is a problem) |
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Term
| if pt has S. Blakemore Tube (for esoph varices)… |
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Definition
| Keep scissors by bed Sudden respiratory distress – Cut inflation tubes and remove |
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Term
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Definition
| Keep Kelly clamp and Obturator (used to insert into trachea then removed leaving cannula) at bed side |
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Term
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Definition
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Term
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Definition
| Take a deep breath and hold it |
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Term
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Definition
| < 4 (gastric juices aspirated) |
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Term
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Definition
| If cough and gag, back off a little, let calm, advance again with pt sipping water from straw |
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Term
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Definition
| End of nose, to era lobe, to xyphoid (~22-26 inches) |
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Term
| Decubitus (pressure) Ulcer Staging |
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Definition
• Stage 1 = Erythema only
• Stage 2 = Partial thickness
• Stage 3 = Full thickness to SQ
• Stage 4 = Full thickness + involving mm /bone |
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Term
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Definition
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Term
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Definition
|
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Term
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Definition
| (verbal enunciation/articulation |
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Term
|
Definition
| perform purposeful movements |
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Term
|
Definition
| (speech and verbal comprehension), |
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Definition
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Definition
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