Term
|
Definition
|
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Term
|
Definition
| Data that can be observed |
|
|
Term
| What is the order when assessing the abdomen |
|
Definition
Look, Listen, Feel
When listening always start at the right lower quad and then right upper, left upper, and left lower....Always in that order |
|
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Term
|
Definition
| Collecting, organizing, validating, and recording data about a pt's health status |
|
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Term
|
Definition
| Sorting, clustering, and analyzing data obtained to form a diagnostic statement |
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Term
|
Definition
| Setting priorities, identifying expected outcomes, and developing specific nursing interventions to resolve or minimize the identified problems |
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Term
|
Definition
| Putting the nursing care plan into action |
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Term
|
Definition
| Assessing the pt's response to the nursing interventions and comparing the response to the expected out come |
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Term
| Where is Apical pulse located |
|
Definition
| Over the heart at the 5th intercostal space |
|
|
Term
| Definition of Labored breathing |
|
Definition
| Means pt is using accessory muscles to breath |
|
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Term
|
Definition
| Color, Odor, Consistency, Amount |
|
|
Term
| Describe bronchial breath sounds |
|
Definition
Loud, "harsh", high pitched sounds
Are created by air moving through the trachea and are heard over the trachea |
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Term
|
Definition
Moderate intensity "blowing" sounds heard as air moves through the larger airways
They are normally heard between the scapula |
|
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Term
|
Definition
| Soft intensity "gentle sighing" sounds heard over the lung periphery as air moves through the smaller airways |
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Term
|
Definition
| Abnormal sounds result from air passing through moisture, mucus, or narrowed airways |
|
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Term
|
Definition
| Fine, short crackling sounds created as air passes through fluid or mucus in any air passage....Most common in bases of loser lobes |
|
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Term
|
Definition
| Continuous, low pitched gurgling, harsh sounds created as air passes through airways narrowed by secretions, swelling or tumors. These sounds predominate over trachea and bronchi |
|
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Term
|
Definition
| Continuous, high pitched, squeaky musical sounds that can be heard over all lung fields as air passes through a constricted bronchi |
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Term
|
Definition
| Superficial grating or creaking sounds created by pleural surfaces rubbing together, They are heard most often over lower anterior and lateral chest (area's of greatest expansion) |
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
| One every three seconds and are loud and rushing sounds |
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Term
|
Definition
| After listening for 3-5 min per quadrant and no sounds are heard |
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Term
|
Definition
|
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Term
|
Definition
|
|
Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
|
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Term
|
Definition
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Term
|
Definition
|
|
Term
| What percent of the body is water |
|
Definition
|
|
Term
|
Definition
| It is what the pt says it is at the level they say it is and for the duration they state |
|
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Term
|
Definition
| Discomfort of any kind and it is subjective |
|
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Term
|
Definition
| Pain that has a rapid onset and goes away in a short amount of time (Broken bone, Kidney stone, etc.) |
|
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Term
|
Definition
| Pain that is constant and lasts more than six months (Arthritis, Cancer, etc.) |
|
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Term
|
Definition
| Resistant to cure or relief |
|
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Term
|
Definition
| Perceived from part no longer present (amputee) |
|
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Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Abdominal cavity or thorax |
|
|
Term
|
Definition
| perceived in area other than location |
|
|
Term
| Effects of untreated pain |
|
Definition
| Can lead to sleep deprivation, fatigue, chronic pain, depression, analgesics become less effective in sleep deprived patients |
|
|
Term
| Two compartments where there is body fluid |
|
Definition
| ICF (Intracellular Fluid, Inside the cell) and ECF (Extracellular Fluid, Outside the cell) |
|
|
Term
|
Definition
| Sometimes fluid is not lost from the body but is unavailable for use by either the ICF or ECF. Loss of ECF into a space that does not contribute to equilibrium between the ICF and the ECF is referred to as a third-space fluid shift, or "third spacing" for short |
|
|
Term
| Third spacing sings and symptoms |
|
Definition
| Increased heart rate, decreased blood pressure, decreased central venous pressure, edema, increased body weight, and imbalances in fluid intake and output |
|
|
Term
|
Definition
| Hypocalcemia, Decreased iron intake, severe liver disease, alcoholism, hypothyroidism, malabsorption, immobility, burns, cancer |
|
|
Term
| Fluid Volume Deficit (FVD)signs and symptoms (Hypovolemia) |
|
Definition
| Postural hypotension, acute weight loss, dry mucous membranes, decreased skin turgor, lassitude, flattened neck veins, delayed capillary refill, decreased CVP, Weak, rapid pulse, Sunken eyeballs, oliguria, concentrated urine, pale, cool, clammy skin, increased temperature, cramps |
|
|
Term
|
Definition
| Elevated BUN, Elevated BUN/Cr ratio, Elevated hematocrit due to decreased plasma volume, Serum electrolytes, increased urine specific gravity |
|
|
Term
| FVE, Fluid Volume Excess (Hypervolemia) |
|
Definition
| Abnormal retention of water or Sodium (Na)(Na levels not always elevated) |
|
|
Term
|
Definition
| Fluid retention leading to weight gain, gallops in the heart, crackles in the lungs, ascites (abdominal distention due to fluid build up), Tachycardia, increased BP, Increased CVP, SOB, Wheezing, increased urine output |
|
|
Term
|
Definition
| Decreased BUN, Decreased Hematocrit level from decreased plasma dilution, CXR may revel pulmonary congestion |
|
|
Term
| Diuretic use for Hypervolemia (FVE) |
|
Definition
| Thiazide diuretics are prescribed for mild to moderate hypervolemia and loop diuretics for severe hypervolemia |
|
|
Term
|
Definition
| Acute weight loss, loss of skin turgor, oligurea, concentrated urine, weak rapid pulse, capillary filling time prolonged, low CVP, hypotension, flattened neck veins, dizziness, weakness, thirst and confusion, rapid pulse, muscle cramps, sunken eyes |
|
|
Term
|
Definition
| Acute weight gain, peripheral edema and ascites, distended jugular veins, crackles, elevated CVP, shortness of breath, hypertension, bounding pulse and cough, increased respiratory rate |
|
|
Term
|
Definition
| Anorexia, nausea and vomiting, headache, lethargy, dizziness, confusion, muscle cramps and weakness, muscular twitching, seizures, papilledema, dry skin, increased pulse, decreased BP, weight gain, edema |
|
|
Term
|
Definition
| Thirst, elevated body temperature, swollen dry tongue and sticky mucous membranes, hallucinations, lethargy, restlessness, irritability, focal or grand mal seizures, pulmonary edema, hyperreflexia, twitching, nausea, vomiting, anorexia, increased pulse and BP |
|
|
Term
|
Definition
| Fatigue, anorexia, nausea and vomiting, muscle weakness, polyuria, decreased bowel motility, ventricular asystole or fibrillation, paresthesias, leg cramps, decreased BP, ileus, abdominal distention, hypoactive reflexes, |
|
|
Term
|
Definition
| Muscle weakness, tachycardia ---> bradycardia, dysrhythmias, flaccid paralysis, paresthesias, intestinal colic, cramps, abdominal distention, irritability, anxiety |
|
|
Term
|
Definition
| Numbness, tingling of fingers, toes, and circumoral region; positive Trousseau's sign and Chvostek's sign; seizures, carpopedal spasms, hyperactive deep tendon reflexes, irritability, bronchospasm, anxiety, impaired clotting time, decreased prothrombin, diarrhea, decreased BP, |
|
|
Term
|
Definition
| Muscular weakness, constipation, anorexia, nausea and vomiting, polyuria and polydipsia, dehydration, hypoactive deep tendon reflexes, lethargy, deep bone pain, pathologic fractures, flank pain, calcium stones, hypertension |
|
|
Term
|
Definition
| Neuromuscular irritability, positive Trousseau's and Chvostek's signs, insomnia, mood changes, anorexia, vomiting, increased tendon reflexes, and increased BP |
|
|
Term
|
Definition
| Flushing, hypotension, muscle weakness, drowsiness, hypoactive reflexes, depressed respirations, cardiac arrest and coma, diaphoresis |
|
|
Term
|
Definition
| Paresthesias, muscle weakness, bone pain and tenderness, chest pain, confusion, cardiomyopathy, respiratory failure, seizures, tissue hypoxia, and increased susceptibility to infection, nystagmus |
|
|
Term
|
Definition
| Tetany, tachycardia, anorexia, nausea and vomiting, muscle weakness, signs and symptoms of hypocalcemia; hyperactive reflexes, soft tissue calcifications in lungs, heart, kidneys, and cornea |
|
|
Term
|
Definition
| Agitation, irritability, tremors, muscle cramps, hyperactive deep tendon reflexes, hypertoncity, tetany, slow shallow respirations, seizures, dyrhythmias, coma |
|
|
Term
|
Definition
| Tachypnea, lethargy, weakness, deep rapid respirations, decline in cognitive status, decreased cardiac output, dyspnea, tachycardia, pitting edema, dysrhythmias, coma |
|
|
Term
|
Definition
| Sudden and rapid deterioration of kidney function that is sometimes reversible |
|
|
Term
|
Definition
| Total urine output less than 50 mL in 24 hours |
|
|
Term
|
Definition
| Type of vascular access for dialysis; created by surgically connecting an artery to a vein |
|
|
Term
|
Definition
| Type of surgically created vascular access for dialysis by which a piece of biologic,semibiologic, or synthetic graft material connects the patient's artery to a vein. |
|
|
Term
|
Definition
| Abnormal concentration of nitrogenous wastes in the blood |
|
|
Term
|
Definition
| Chronic progressive and irreversible diseases of the kidneys |
|
|
Term
|
Definition
| Solution that circulates through the dialyzer in hemodialysis and through the peritoneal membrane in peritoneal dialysis |
|
|
Term
|
Definition
| Movement of solutes (waste products) from an area of higher concentration to an area of lower concentration |
|
|
Term
|
Definition
| Term used to describe the drained fluid from a peritoneal dialysis exchange |
|
|
Term
|
Definition
| Final stage of renal failure that results in retention of uremic waste products and the need for renal replacement therapies |
|
|
Term
|
Definition
| Inflammation of the glomerular capillaries |
|
|
Term
|
Definition
| Type of renal failure with increased glomerular permeability and massive proteinuria |
|
|
Term
|
Definition
| Any substance, medication, or action that destroys kidney tissue |
|
|
Term
|
Definition
| Movement of water through a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration |
|
|
Term
|
Definition
| An excess of urea and other nitrogenous wastes in the blood |
|
|
Term
|
Definition
•Proteins secreted by damaged kidney tubules
•Casts in the urine look like a cell but it is kinda oblong or funny shape cell in the urine, this will sometimes help to diagnose if it's glomerular nephritis or it it's a hereditary disease |
|
|
Term
| Chronic renal failure or ESRD (End Stage Renal Disease) |
|
Definition
| A progressive, irreversible deterioration in renal function, The body is unable to maintain metabolic and fluid and electrolyte balance resulting in uremia or azotemia |
|
|
Term
| CKD (Chronic Kidney Disease) |
|
Definition
| An umbrella term that describes kidney damage or a decrease in the glomerular filtration rage (GFR) for 3 or more months. CKD is associated with decreased quality of life, increased health care expenditures, and premature death. If left untreated CKD can result in ESRD and necessitate renal replacement therapy (dialysis or kidney transplant). |
|
|
Term
| What lab values will be elevated with renal failure? |
|
Definition
| Elevated serum creatinine levels indicate underlying kidney disease; as the creatinine level increases, symptoms of CKD begin. |
|
|
Term
|
Definition
| Anemia is caused because the kidney produces less erythropoietin |
|
|
Term
| Major functions of the kidney |
|
Definition
•Rid body of excess waste products
•Rid body of excess fluids
•Regulate fluid and chemicals in the body
•Regulate blood pressure
•Stimulates the production of RBC's
•Regulation of acid base balance
•Metabolism of Vit D
•Synthesis of prostaglandin |
|
|
Term
|
Definition
•Diabetes mellitus (leading cause)
•Hypertension
•Chronic glomerulonephritis
•Pyelonephritis
•Obstruction of the urinary tract
•Hereditary disorders (polycystic kidney disease and Alports syndrome)
•Vascular disorders
•Infections
•Medications
•Toxic agents
•Environmental and occupational agents |
|
|
Term
| The rate of decline in renal function and progression of disease is related to what? (In CRF) |
|
Definition
| Underlying disorder, urinary excretion of protein, and presence of hypertension |
|
|
Term
| CRF progresses faster in patients with what? |
|
Definition
| The disease tends to progress more rapidly in patients who excrete significant amounts of protein or have elevated blood pressure than in those without these conditions. |
|
|
Term
|
Definition
•As renal function declines, end products of protein metabolism accumulate in the blood
•Uremia develops affecting body systems
•The greater the build op of waste products the greater the symptoms |
|
|
Term
| What are the three stages of chronic renal disease |
|
Definition
•Reduced renal reserve- 40-75% loss of nephron function
•Renal insufficiency- occurs when 75-90% of nephron function is lost
•End stage renal disease (ESRD)- the final stage of CRF, occurs when there is less then 10% nephron function remaining |
|
|
Term
| S/S of Uremia (A clinical manifestation of ESRD) |
|
Definition
•Swelling of hands and face
•Fatigue
•Nausea and vomiting
•Loss of appetite
•Headache
•Blurred vision
•Pruritus
•Shortness of breath |
|
|
Term
|
Definition
|
|
Term
| Neurological symptoms with clinical manifestations of CRF |
|
Definition
•Weakness and fatigue
•Confusion and inability to concentrate
•Disorientation
•Twitching and tremors
•Seizures
•Restlessness of legs
•Burning of soles of feet
•Behavior changes |
|
|
Term
| Cardiovascular symptoms in clinical manifestations of CRF |
|
Definition
•Hypertension
•Pitting edema
•Periorbital edema
•Pericardial friction rub
•Engorged neck veins
•Pericarditis
•Pericardial effusion
•Pericardial tamponade
•Hyperkalemia
•Hyperlipidemia |
|
|
Term
| Pulmonary symptoms in clinical manifestations of CRF |
|
Definition
•Crackles
•Thick, tenacious sputum
•Pleuritic pain
•Shortness of breath
•Tachypnea
•Kussmal type respirations
•Uremic pneumonitis (Uremic lung)
•Pulmonary edema |
|
|
Term
| GI symptoms in clinical manifestations of CRF |
|
Definition
•Ammonia odor to breath (Uremic fetor)
•Metallic taste in mouth
•Mouth ulcerations and bleeding
•Nausea, vomiting, and anorexia
•Hiccups
•Constipation or diarrhea
•Gastrointestinal bleeding |
|
|
Term
| Hematological Symptoms in clinical manifestations of CRF |
|
Definition
|
|
Term
| Reproductive symptoms in clinical manifestations of CRF |
|
Definition
•Amenorrhea
•Testicular atrophy
•Infertility
•Decreased libido |
|
|
Term
| Musculoskeletal symptoms in clinical manifestations of CRF |
|
Definition
•Muscle cramps
•Loss of muscle strength
•Renal osteodystrophy
•Bone pain
•Bone fractures
•Foot drop
•Carpal tunnel syndrome |
|
|
Term
| Integumentary symptoms in clinical manifestations of CRF |
|
Definition
•Changes in skin color
•Dry, flaky skin
•Pruritus
•Uremic frost
•Ecchymosis
•Purpura
•Thin, brittle nails
•Coarse, thinning hair |
|
|
Term
|
Definition
•24 hour urine for creatinine clearance
•BUN
•Creatinine |
|
|
Term
| What will be elevated in Azotemia |
|
Definition
| Elevation of both BUN and Cr |
|
|
Term
| Non-renal reasons for BUN to be elevated |
|
Definition
•Increased protein intake
•Corticosteroids
•Dehydration
•Blood in the GI tract
•Fever
•Starvation and catabolism |
|
|
Term
| Environmental and Occupational agents that can contribute to ESRD |
|
Definition
| Lead, cadmium, mercury, and chromium |
|
|
Term
|
Definition
| Patient usually does not have symptoms because the remaining nephrons are able to carry out the normal functions of the kidney. No symptoms at this point |
|
|
Term
|
Definition
| Serum creatinine and blood urea nitrogen rise, the kidney loses its ability to concentrate urine and anemia develops. Patient may report polyuria and nocturia. |
|
|
Term
|
Definition
| All of the normal regulatory, excretory, and hormonal functions of the kidney are severely impaired. ESRD is evidenced by elevated creatinine and blood urea nitrogen levels as well as electrolyte imbalances. Once patient reaches this point the patient will show S/S of uremia and dialysis is usually indicates. Many of the symptoms of uremia are reversible with dialysis. |
|
|
Term
| Urinalysis studies for assessment and diagnostic findings |
|
Definition
•24 hour urine for creatinine clearance
•Protein
•Urea, albumin, Na, Cl, K
•RBC's
•Casts |
|
|
Term
| When is acute dialysis needed |
|
Definition
| With high and increasing levels of serum potassium, fluid overload, impending pulmonary edema, or increasing acidosis |
|
|
Term
| What is the treatment for metabolic acidosis in a CRF patient |
|
Definition
| No treatment, In a CRF patient there are usually no symptoms and so therefor no treatment is needed |
|
|
Term
| Assessment and diagnostic findings during sodium and water retention in patient with ESRD |
|
Definition
•The kidney cannot concentrate or dilute urine normally
•Appropriate responses by the kidney to changes in daily intake of water and electrolytes do not occur
•In some patients retention of sodium and water result in: edema, heart failure, hypertension
•Some patients may have a tendency to lose salt resulting in: hypotension and hypovolemia |
|
|
Term
| What causes metabolic acidosis in pt's with ESRD |
|
Definition
•Metabolic acidosis occurs because the kidney cannot excrete increased loads of acid
•Decrease acid secretion primarily results from inability of the kidney tubule to excrete ammonia and to reabsorb sodium bicarbonate |
|
|
Term
| What are the causes of Anemia in pt's with ESRD |
|
Definition
•Inadequate production of erythropoietin
•Shortened life span of RBC's
•Nutritional deficiencies
•High risk for bleeding |
|
|
Term
| S/S of profound anemia in pt's with ESRD |
|
Definition
•Fatigue
•SOB
•Angina
•H&H values |
|
|
Term
| What electrolyte imbalances are common in pt with ESRD |
|
Definition
•Hyperphosphatemia and Hypocalcemia (Remember that serum calcium and phosphate levels have a reciprocal relationship in the body: as one rises the other decreases)
•Also watch Potassium and Sodium level's as they will change as well
•Hyperkalemia due to decrease excretion, metabolic acidosis, catabolism, and excessive intake (diet, medications, fluids)
•If pt is renal and codes then be sure to check most recent K levels because the reason that the pt coded could be that they are hyperkalemic |
|
|
Term
| How would Hyperphosphatemia and hypocalcemia be treated in a pt with ESRD |
|
Definition
| Hyperphosphatemia and hypocalcemia are treated with aluminum based antacids that bind dietary phosphorus in the GI tract. Also binds dietary phosphorus in the intestinal tract and permits use of smaller doses of antacids. Must be administered with food to be effective |
|
|
Term
| Which type of medications need to be withheld during dialysis?? |
|
Definition
| Water soluble medications need to be held as these will be removed from the blood during dialysis so the patient will not benefit from these so hold prior to dialysis |
|
|
Term
| What type of things will be held or increased in patient with ESRD (Nutritional therapy) |
|
Definition
Restrict:
•Protein
•Sodium
•Potassium
•Phosphorous
•Fluids (500 to 600 ml more than the previous day's 24 hour output)
Increase:
•Calories (unless diabetic)
(60 gram protein, 2 gram sodium, 3 gram potassium, low phosphorus, 2000 calorie diet) |
|
|
Term
| Conditions that patients with CRF will always have |
|
Definition
•Anemia, because the kidney's are responsible for production of RBC's and when the kidney's fail production goes down
•Hypocalcemia because the synthesis of vitamin D is impaired |
|
|
Term
| What are the two things that cause CRF that are hereditary |
|
Definition
Polycystic kidney disease and Alports syndrome
These are the only two causes that have been proven to be hereditary |
|
|
Term
| What are the common traits and views about Alports syndrome |
|
Definition
| Patients with Alports syndrome are hearing impaired, the connection is that the kidney's and the ears develop at the same time in utero and for some reason they both stop developing at the same time |
|
|
Term
| What is a common sickness that can lead to kidney failure |
|
Definition
| Strep, This is the most common infection that can lead to kidney disease, if a pt has strep all the time and it is not treated or the antibiotics are not completed so it is not gone completely then it can spread to the kidney's and destroy them |
|
|
Term
| What is the highest priority when you have a patient with renal failure |
|
Definition
| Finding the cause, when the cause if found then you can treat that and slow the progression |
|
|
Term
| Lab value to qualify as thrombocytopenia |
|
Definition
| Platelet count less than 100,000 qualifies as thrombocytopenia, if count is around 20,000 this is a major risk, bleeding out is a major risk as well |
|
|
Term
| What causes carpal tunnel in a patient with CRF |
|
Definition
| Carpal tunnel from build up of amyloid, a paraprotein deposition around the medial nerve causing compression |
|
|
Term
| What are ecchymosis and purpura |
|
Definition
| Bleeding in the skin (kinda of like petechia only bigger) |
|
|
Term
|
Definition
|
|
Term
| What is one of the most important things to remember with a 24 hour urine |
|
Definition
| Discard the first void and collect from that point forward for 24 hours, keep the collection on ice, if pt has a Foley then keep Foley bad on ice |
|
|
Term
| BUN/Cr ratio in a patient with CRF |
|
Definition
| The BUN/Cr ratio will usually be normal in a patient with CRF because both lab values will be elevated and they usually elevate at about the same rate so the ratio will stay normal as both levels rise. Look at levels though because even though the ratio is normal the levels will be elevated |
|
|
Term
| Common tests done to determine cause for renal failure |
|
Definition
| IVP (Intravenous Pilogram: The pt will have a contrast or dye injected into the IV and this will help to look at the size and shape of the kidney and also look at the veins and arteries to see if there is an issue such as the blood not perfusion as well on once side or the other and also to see if one kidney is smaller than the other), CT, Renal angiography, Renal scanning, Renal biopsy (assess for bleeding) |
|
|
Term
| The three steps to hemodialysis |
|
Definition
•Diffusion- movement of particles
•Osmosis- movement of water
•Ultrafiltration- removal of fluid by applying negative pressure on dialysate compartment |
|
|
Term
|
Definition
| Clearance is the removal of waste products from the blood in a given unit of time |
|
|
Term
| What is the most important additive in dialysate? |
|
Definition
| Glucose- it is important because it is what causes increased osmotic pressure |
|
|
Term
| What are things you need to watch for if a patient has a fistula for dialysis |
|
Definition
| Should be able to feel the blood flowing when you touch it, can use stethescope to hear the blood flowing, make sure that it is not clotted off because patient will need to go back to surgery if this happens, also need to watch and make sure that it does not become dislodged, Infection is also a risk so keep area clean to prevent infection, teach patient not to sleep or lay on the side that has the fistula and also no needle sticks or BP are to be taken on that arm |
|
|
Term
| What are some possible complications during dialysis |
|
Definition
| Hypertension, cramps, bleeding/clotting, dialyzer reaction, hemolysis, dysrhythmias, infections |
|
|
Term
| What is the cause of hypertension during dialysis |
|
Definition
| With dialysis blood is being pulled out of the patient to be cleaned so the blood volume goes down so the heart is having to work harder |
|
|
Term
| What is the cause of hypertension during dialysis |
|
Definition
| With dialysis blood is being pulled out of the patient to be cleaned so the blood volume goes down so the heart is having to work harder |
|
|
Term
| What are some possible complications during dialysis |
|
Definition
•Hypertension
•Cramps
•Bleeding/Clotting
•Dialyzer reaction
•Hemolysis
•Dysrhythmias
•Infections
•Hypoxemia
•Vascular access dysfunction
•Disequilibrium syndrome
•Pyrogen reactions
•Technical mishaps- incorrect dialysate mixture, contaminated dialysate, or air embolism |
|
|
Term
| S/S of disequilibrium syndrome and what causes it |
|
Definition
| Dialysis disequilibrium results from cerebral fluid shifts. Signs and symptoms include headache, nausea, vomiting, restlessness, decreased level of consciousness, and seizures. It is more likely to occur in ate renal failure or when blood urea nitrogen levels are very high (exceeding 150 mg/dL) |
|
|
Term
| The three steps in Peritoneal dialysis |
|
Definition
•Inflow
•Dwell time
•Outflow |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Male 85-125 mL/min
Female 75-115 mL/min
For each decade after 40 years - 6-7 mL/min |
|
|
Term
|
Definition
|
|
Term
|
Definition
Male 13-18 gm/dL
Female 12-16 gm/dL |
|
|
Term
|
Definition
Male 42%-52%
Female 35%-47% |
|
|
Term
|
Definition
|
|
Term
|
Definition
Neutrophils 45-70%
Lymphocytes 20-40%
Monocytes 2-8%
Eosinophils 0-4%
Basophils 0-1% |
|
|
Term
| ANC (Absolute Neutrophil Count) |
|
Definition
› 1500 cells/mm3
‹ 1500 – risk for infection increases
‹ 1000 – high risk for infection institute neutropenia precautions
‹ 500 – avoid peripheral IVs; central lines preferred with meticulous care |
|
|
Term
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Definition
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| Fibrin degradation products |
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| CD4/CD8 ratio (Helper T Cells and Suppressor T Cells) |
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| RT-PCR (measures viral load in HIV/AIDS pt's) |
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| The five right's of med administration and the sixth one for the test |
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Right patient
Right medication
Right dose
Right time
Right route
Right documentation |
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| Last 5 rights of med admin |
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Right documentation
Right assessment
Right to education
Right evaluation
Right to refuse |
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U for unit
IU for international unit
QOD for every other day
cc instead use mL
if a whole number no trailing zero after decimal and if less than one make sure there is a leading zero in front of the decimal |
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| How many pt identifiers when performing procedures or administering med |
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2 forms
ex. Name and Birthdate |
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| Five goals related to medication safety from the 2010 National Patient Safety Goals |
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Goal 1- Accuracy of patient identification
Goal 2- Effectiveness of communication
Goal 3- Improve safety of using medications
Goal 7- Reduce the risk of health care associated infections
Goal 8- Reconciliation of medications |
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Pt name
Med name
Dosage
Route
Frequency
Date
Dr signature |
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| How many checks when preparing meds |
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| When do you document meds |
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| Immediately after administration |
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| Factors that modify the drug response |
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Absorption
Distribution
Metabolism (biotransformation)
Excretion
Age
Body weight
Toxicity
Pharmacogenetics
Route of administration
Time of administration
Emotional factors
Preexisting disease state
Drug history
Tolerance
Cumulative effect
Drug-drug interaction
Drug-food interaction |
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| Types of liquid medication |
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Elixirs (sweetened)
Emulsions (mixture of 2 liquids)
Suspensions (particles mixed/ not dissolved) |
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| A patch placed on the skin- medication is absorbed into systemic circulation |
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| What are the four types of injectable routes |
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Intradermal (TB test, just under skin makes a bleb)
Subcutaneous (heparin/insulin injected into the fatty tissue)
Intramuscular (medication that is injected into the muscle tissue)
Intravenous (medication injected through the IV) |
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Ventral mid-forearm
Clavicular area of the chest
Scapular area of the back |
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| Syringe and needle used for intradermal injection |
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| Tuberculin syringe 1mL and a 25-27 gauge needle 3/8-5/8 inches long |
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| Procedure for intradermal injection |
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Cleanse the area with a circular motion
hold skin taut
Insert needle bevel up at a 10-15 degree angle just under the skin far enough to cover the bevel
Inject medication, should see a bleb form
Remove needle and dispose in sharps
Do not massage the area
assess for reaction in 24-72 hours |
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| Action for subcutaneous injection |
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Systemic effect
Sustained effect; absorbed mainly through capillaries; usually slower in onset than with the IM route
Used for small doses of nonirritating, water soluble drugs |
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Abdomen
Upper hips
Upper back
Lateral upper arms
Lateral thighs |
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| Syringe and needle needed for a subQ injection |
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1 to 3 mL syringe with a 25-27 gauge needle 1/2 to 5/8 inches long
Insulin syringe for insulin injection |
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Cleanse area with alcohol pad in a circular motion
Pinch the skin where you are going to give the injection
Insert needle at 45 or 90 degree angle (depending on subQ tissue)
Release the skin
Inject medication slowly
Remove needle quickly and dispose of
Gently massage the area unless contraindicated
Apply gentle pressure to the injection site to prevent bleeding or oozing into the tissue and subsequent bruising and tissue damage, especially if the client is on anticoagulant therapy |
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Systemic effect
Usually more rapid effect of drug than with the subQ route
Used for irritating drugs, aqueous suspensions, and solutions in oil |
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Ventrogluteal
Dorsogluteal
Deltoid
Vastus lateralis
Ventrogluteal is the preferred site for adults and toddlers with gluteal muscle development associated with firmly established walking |
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| Needle and syringe for IM injection |
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Needle 20 to 23 gauge and 1 to 1 1/2 inches long (18 gauge for blood products)
Syringe usually 1 to 3 mL |
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| Steps for an IM injection |
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Cleanse area with alcohol swab in a circular motion
pull skin taut with thumb and forefinger and insert needle at 90 degree angle and aspirate to make sure not in a vessel and if no blood return then inject medication
Remove needle quickly and dispose of needle appropriately and apply gentle pressure to injection site to prevent bleeding or oozing |
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cleanse the area with an alcohol swab in a circular motion
Pull skin to one side and hold
Insert needle, aspirate, and inject medication (while still holding skin to the side)
Wait 10 sec and then withdraw needle and release skin and dispose of needle |
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| Hypokalemia signs and symptoms |
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| nausea and comiting, polyuria, confusion, dysrythmia, abdominal distention, and soft, flabby muscles |
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| Hyperkalemia signs and symptoms |
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| nausea, abdominal cramps, oligurea, tachycardia and later bradycardia, weakness, and numbness or tingling in the extremities. For mild hyperkalemia foods rich in potassium are usuallly restricted. |
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| Include dextrose and water (D5W0, Normal saline (NS), and Lactated Ringer's solution (LR) |
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| Volume expanders that include dextran solutions, amino acids, hetastarch, and plasmanate. |
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Potassium (K+)
Soduim (Na+)
Calcium (Ca+)
Magnesium (Mg2+) |
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Chloide ((Cl-)
Bicarbonate (hco3-)
Phospate (PO4-)
Sulfate (SO4-) |
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| Whole blood, packed red blood cells (RBC's), plasma, and albumin |
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| Lipids are administered as fat emulsion solution and are usually idicatd when IV therapy lasts longer than 5 days. Examples TPN and Hyperalimentation (HA) |
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| Works by exchanging Na for K in the intestines and then the K is filtered out in the kidney's and excreted in the urine |
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| Hyponatremia signs and symptoms |
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| Muscle weakness, headaches, lethergy, confusion, seizure, abdominal cramps, nausea and vomiting, tachycardia and hypotension, pale skin, and dry mucous membranes |
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| Hypernatremia sign's and symptom's |
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| Flushed, dry skin: agitation; elevated body temperature; rough, dry tongue; nausea and vomiting; anorexia; tachycardia; hypertension; muscle twitching; and hyperreflexia |
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| Cheese, Yogurt, Milk, Sardines, Dark leafy greens, Soy beans, and Fortified cereals |
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| Legumes, Whole grain breads, Meat, Milk, Eggs, Coffee, Tea, Cocoa, Many fruits and vegetables |
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| Bacon, Beef cubes, Ketchup, Corned beef, Dill, Ham, Soda crackers |
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| Sources high in Magnesium |
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| Mg antacids, Laxatives, Opioids, and Anticholinergics |
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| What are the 8 major functions of the kidneys |
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•Rid body of excess waste products
•Rid body of excess fluids
•Regulate fluid and chemicals in the body
•Regulate blood pressure
•Stimulates the production of red blood cells
•Regulation of acid-base balance
•Metabolism of vitamin D
•Synthesis of prostaglandin |
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