Term
| Pheochromocytoma definition & dx |
|
Definition
increased epi & norepi
dx: VMA (vanillylmandelic acid) 24hour urine |
|
|
Term
|
Definition
Levothyroxine (Synthyroid)
Thyroglobulin (Proloid)
Liothyronine (Cytomel) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Thyroidectomy Post Op Position |
|
Definition
|
|
Term
| Radioactive Iodine Precautions |
|
Definition
-No kissing for 24 hours
-Avoid children for 24 hours
-Watch for thyroid storm (Graves x1000)
-Hypothyroidism (expected) |
|
|
Term
|
Definition
1. Antithyroids (PKU & Tapazole)
2. Iodine Compounds (SSKI & Lugol's)
3. Beta Blockers (Propanolol)
4. Radioactive Iodine |
|
|
Term
| Beta Blockers Contraindicated In |
|
Definition
|
|
Term
| Potassium Iodine (SSKI) & Strong Iodine Solution (Lugol's) |
|
Definition
| Decreases the size & vascularity of the thyroid gland |
|
|
Term
| Propylthiouracil (PKU) & Methimazole (Tapazole) |
|
Definition
| Used preoperativey to stun the thyroid gland in Graves Disease |
|
|
Term
| D/C Iodine containing meds ___ wks prior to thyroid scan |
|
Definition
|
|
Term
|
Definition
-Severe hypotension
-Vascular Collapse |
|
|
Term
|
Definition
Increased Potassium, Protein, and Calcium
Decreased Na |
|
|
Term
| Steroids excrete ___ in the GI tract |
|
Definition
| Calcium (leads to osteoporosis) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| ANP (Atrial Naturetic Peptide) |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Enzymatic Drugs
-Sutilanis (Travase)
-Collagenase (Santyl)
-Not on face
-Not if pre go
-Not over large nerves
-Not on area open to body cavity |
|
|
Term
|
Definition
Nephrotoxicity (Increased BUN & Creatinine)
Ototoxicity (Any hearing complaints) |
|
|
Term
| "Thrombocytopenia" Questions |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Any time giving chemo drugs, must have? |
|
Definition
|
|
Term
| Most important lab value to prevent infections |
|
Definition
|
|
Term
| #1 Risk factor for Cervical Cancer |
|
Definition
|
|
Term
| Major symptom of uterine cancer |
|
Definition
|
|
Term
|
Definition
D&C and Endometrial Biopsy
-Ca-125 to look for ovarian involvement |
|
|
Term
| Hysterectomy Major Complication |
|
Definition
|
|
Term
| Chemo Drugs for Uterine Cancer |
|
Definition
Doxorubin (Adriamycin)
Cisplatin (Platinol-AQ)
Taxol |
|
|
Term
| Grave's Disease Definition |
|
Definition
|
|
Term
|
Definition
Medroxyprogesterone (Depo-provera)
Tamoxifen (Nolvaden) |
|
|
Term
| Two Functions of Lymphatic System |
|
Definition
-Fight infection
-Promote drainage |
|
|
Term
|
Definition
Connection made btwn trachea & esophagus for those post total laryngectomy
Once fistula heals, clients can insert soft plastic device & move air from lungs to the trachea & then over to the esophagus & out of the mouth |
|
|
Term
| Estrogen Synthesis Inhibitors |
|
Definition
|
|
Term
| When Rectal Temp is contraindicated |
|
Definition
-Immunosuppressed
-Thrombocytopenia
-Abdominal resection |
|
|
Term
| Total Laryngectomy position post op |
|
Definition
| Semi-fowlers (35 to 45 degrees) |
|
|
Term
| Early s/s of dumping syndrome |
|
Definition
-Dizziness
-Hypotension
-Syncope
-Sweating
-Tachycardia
-Palpitations
-Nausea
-Diarrhea |
|
|
Term
| 5 Digit system for maternal |
|
Definition
# of pregnancies
#term
#preterm
#abortions
#living children |
|
|
Term
| Ostomy pt foods to decrease odor |
|
Definition
-Parsley
-yogurt
-buttermilk
-cranberry juice |
|
|
Term
| Pneumonectomy Post op Position |
|
Definition
| Position on affected side |
|
|
Term
| Respiratory Alkalosis S/s |
|
Definition
Lightheaded
Faint
Perioral numbness
Numbness/tingling in fingers & toes |
|
|
Term
|
Definition
Pre: Supine, right arm above head
Post op: Lie on right side |
|
|
Term
|
Definition
| bruising around flank area |
|
|
Term
|
Definition
| bruising around umbilical cord |
|
|
Term
|
Definition
During hemodialysis, solutes are removed too quickly from blood than CSF & brain- leading to fluid pulled into the brain (cerebral edema)
-N/V
-HA
-HTN
-Restless/agitated/confused
-Muscle cramps
-Seizure |
|
|
Term
| Food to be excluded when taking cyclosporine |
|
Definition
|
|
Term
| Bladder trauma pain is in the lower abdomen and radiates to the |
|
Definition
|
|
Term
| Manifestations of Urethritis disorder in males |
|
Definition
-Dysuria
-Penile discharge |
|
|
Term
| Kidney Rejection Acute & Chronic Time Frame |
|
Definition
Acute: w/ in two weeks
Chronic: months to years |
|
|
Term
| Post hemodialysis pt complains of HA, nausea, and restlessness |
|
Definition
CALL DR
-Disequillibrium Syndrome |
|
|
Term
| Increased temp post hemodialysis |
|
Definition
| slight elevation is normal due to warming dialysate |
|
|
Term
|
Definition
-Fever
-N/V
-Painful scrotal edema |
|
|
Term
|
Definition
-Done in ICU
-Never more than 80ml's at 1 time
-Who?: Fragile cardio status, acute renal failure |
|
|
Term
| Peritoneal Dialysis Client Diet |
|
Definition
|
|
Term
| Major Complication of Peritoneal Dialysis |
|
Definition
Peritonitis
#1: Cloudy effluent
#2: Abdominal Pain |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Meds to Hold before dialysis |
|
Definition
1. BP meds
2. Nitro
3. Water soluble vitamins
4. Ampicilin |
|
|
Term
|
Definition
-Done 3-4x week
-Heparin tx (watch for bleeding)
-Electrolytes & BP watched closely
-Unstable cardio system can't handle
-Depressed/suicide |
|
|
Term
| Manifestations of Urethritis Disorder in males |
|
Definition
-Dysuria
-Penile Discharge |
|
|
Term
| Kidney Rejection Acute & Chronic |
|
Definition
Acute: w/in 2 weeks
Chronic: months to years |
|
|
Term
| Post Hemodialysis pt complains of headache, nausea, and restlessness |
|
Definition
CALL THE DR
pt is experiencing disequilibrium syndrome |
|
|
Term
| Elevated temp post hemodialysis |
|
Definition
| Normal- from warming of dialysate |
|
|
Term
|
Definition
-Fever
-N/V
-Painful scrotal edema |
|
|
Term
|
Definition
-Done in ICU only
-Never more than 80mL's at 1 time
-Who?: -Fragile Carido status or Acute Renal Failure |
|
|
Term
| Peritoneal Dialysis Client Diet |
|
Definition
|
|
Term
| Major complication of Peritoneal Dialysis |
|
Definition
Peritonitis
#1: Cloudy effluent
#2: Abdominal Pain |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Meds to hold before dialysis |
|
Definition
-Nitro
-BP meds
-Ampicillin
-Water Soluble Vitamins |
|
|
Term
|
Definition
-3-4times/week
-Heparin tx (watch for bleeding)
-Electrolyte & BP monitored closely
-Unstable cardiac pt can't handle
-Depressed/suicide |
|
|
Term
| Diuretic phase of kidney failure |
|
Definition
-Acute onset
1. FVD
2. Hypokalemia |
|
|
Term
| Oliguric phase of kidney failure |
|
Definition
-1-3 weeks
1. FVE
2. Hyperkalemia |
|
|
Term
|
Definition
-Increased BUN/Creatine
-Anemia
-HTN/HF
-Itching frost
-Hyperkalemia
-Metabolic Acidosis
-Retain phosphorus -> decreased Calcium (pull from bones)
-Increased/fixed urine specific gravity |
|
|
Term
|
Definition
-Diuretics
-Ace Inhibitors (block aldosterone)
-Lipid lowering drugs
-Decreased Na
-INcreased protein
-Anticoagulation therapy for 6 months
-Dialysis |
|
|
Term
| S/S of Nephrotic Syndrome |
|
Definition
1. Proteinureia
2. Hypoalbumina
3. Hyperlipidema
4. Anasarca |
|
|
Term
| Complications of Nephrotic Syndrome |
|
Definition
-Blood clots
-Increased cholesterol/triglycerides |
|
|
Term
|
Definition
| Inflammation response in Glomerulus -> loss of protein -> decreased circulating volume of albumin -> decreased BP & UO -> ANSARCA (total edema) |
|
|
Term
|
Definition
-Malaise, HA
-Anorexia
-N/V
-Decreased UO
-Increased weight |
|
|
Term
|
Definition
-Decreased protein
-Decreased na
-Increased carbs |
|
|
Term
| Fluid Replacement Determination |
|
Definition
|
|
Term
|
Definition
-Sore throat
-Malaise/ headache
-Flank pain
-Increased BP
-Facial edema
-Decreased urinary output |
|
|
Term
| Lab Values Glomerulonephritis |
|
Definition
-Increased BUN/ Creatinine
-Sediment/protein/blood in urine
-Increased urine specific gravity |
|
|
Term
|
Definition
-Position on side
-Stay w/ client
-Temporary memory loss
-Reorient
-Involve in ADL's ASAP
-should have no pain |
|
|
Term
|
Definition
1. NPO, void
2. Atropine (to dry up)
3. Signed permission
4. Anectine (to relax muscles) |
|
|
Term
| Hallucinations Nursing Consideration |
|
Definition
1. Involve in activity
2. Increase HOB
3. Turn off TV
4. Reassure
5. Tell before touching |
|
|
Term
| Panic Disorder Nursing Consideration |
|
Definition
1. Stay 6ft away
2. Simple words
3. Symptoms peak w/in 10 mins
4. Journaling
5. Relaxation techniques |
|
|
Term
|
Definition
1. Sit w/ client at meals & 1 hour after
2. Allow 30mins for meal
3. Self-esteem building important |
|
|
Term
|
Definition
1. Anxiolytics
2. Detox protocols (thiamine, multi vitamine, magnesium)
3. Antabuse (stay away from all alcohol, sign consent)
4. 12-step program |
|
|
Term
| Stages of Alcohol Withdrawl |
|
Definition
Stage 1: mild tremors, nervous, nausea
Stage 2: increased tremors, hyperactive, nightmares, disorientation, hallucinations, increased HR, increased BP
**DT's- keep light on**
Stage 3: Severe hallucinations, grand mal seizures |
|
|
Term
|
Definition
1. Structured schedule
2. Give time for rituals
3. Do NOT verbalize disapproval
4. Time delay techniques
5. Relaxation techniques
6. SSRI's
7. TCA |
|
|
Term
|
Definition
1. Stay w/ client
2. Step-by-step instructions
3. Short term anxiolytics
4. Relaxation techniques (deep breathing, imagery, deep muscle relaxation)
5. Journaling |
|
|
Term
|
Definition
1. Be reliable
2. Brief visits (careful w/ touch)
3. Avoid whispering
4. Don't mix meds
5. Be matter of fact
6. Eat sealed foods (from home)
7. Consistent nurses
8. No competitive activits
9. Be honest |
|
|
Term
|
Definition
|
|
Term
|
Definition
1. Safe environment
2. Safe-proof room
3. Contract to post pone
4. Direct, closed-ended statements
5. Re-channel anger (physically)
6. Stay calm |
|
|
Term
| Mania Nursing Consideration |
|
Definition
-Decrease stimuli
-Decrease group activities
-One-on-one relationships
-Remove hazards (watch w/ cigs)
-Stay w/ client
-Structured schedule (writing activities)
-Brief encounters w/ staff
-Weigh daily (finger foods)
-Don't argue or try to reason
*nothing to stimulate client* |
|
|
Term
| Pt with a past history of iron deficiency anemia is being treated for a DVT w/ heparin |
|
Definition
| worry if the pt even has a nose bleed |
|
|
Term
| Intermittent Claudication |
|
Definition
ONLY IN ARTERIAL INSUFFICIENCY
-Pain caused by walking |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Nitro is used for the treatment of angina for which reason? |
|
Definition
| decreases preload (by dilating peripheral vessels) |
|
|
Term
| Dopamine via IV most important factor |
|
Definition
|
|
Term
| Depressed client, sudden shift in attitude for the better |
|
Definition
|
|
Term
| Post MI client's UO decreases from 60mL/hr then to 30mL/hr. what's the cause? |
|
Definition
|
|
Term
| Acute Aspirin Overdose ABG Problem |
|
Definition
|
|
Term
| Metabolic Acidosis Causes |
|
Definition
-DKA
-Starvation
-Renal Failure
-Severe diarrhea |
|
|
Term
| Metabolic Alkalosis Causes |
|
Definition
-Loss of upper GI contents (vomiting, suction)
-Too many antacids
-too much IV bicarb |
|
|
Term
| Serum K in Metabolic Alkalosis |
|
Definition
| Hypokalemia (watch for muscle craps & arrhythmias) |
|
|
Term
| Serum K in Metabolic Acidosis |
|
Definition
|
|
Term
| Most frequent cause of tetany |
|
Definition
|
|
Term
|
Definition
Active immunity
(takes 2-4 weeks to develop their own immunity) |
|
|
Term
|
Definition
Immediate Protection
Passive immunity |
|
|
Term
|
Definition
| ordered to flush out kidneys & prevent kidney failure |
|
|
Term
| Electrolyte imbalance w/ burn victim |
|
Definition
|
|
Term
| Increased risk of paralytic illeus |
|
Definition
-decreased vascular volume
-decreased GI motility
-Hyperkalemia |
|
|
Term
|
Definition
Retain Na & H2O
Increased in: Cushing, Conn's
Decreased in: Addisons |
|
|
Term
|
Definition
hypocalemia & hypomagnesemia
-pump up BP cuff & hand starts to tremor |
|
|
Term
|
Definition
hypocalemia & hypomagnesemia
-tap cheek |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
spinach
mustard greens
summer squash
brocolli
halibut
turnip greens
pumpkin seeds
peppermint
cucumber
green breans
celery
kale
sunflower seeds
seasame seeds
flax seeds |
|
|
Term
| Isotonic Solutions "crystalloids" |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Hypertonic Solutions "Coloid" |
|
Definition
D10W
3% NS
5% NS
D5LR
D51/2NS
D5NS
TPN
Albumin |
|
|
Term
|
Definition
-Emotions labile
-Moody
-Tire easily |
|
|
Term
|
Definition
-Post alcohol detox (decreased thiamine/niacin)
-Disoriented to time
-Confabulate |
|
|
Term
|
Definition
-Decreased stimuli
-Observe frequently
-Orient frequently
-Keep convo reality based
-Meet personal needs |
|
|
Term
|
Definition
-For burn pts
4ml/kg/TBSA
1/2 first 8 hours
1/4 next 8 hours
1/4 next 8 hours |
|
|
Term
|
Definition
Head/neck 9%
Chest 18%
Back 18%
Each arm 9%
Each leg 18%
Perineum 1% |
|
|
Term
|
Definition
Increases fluid in the vascular space
-Increased volume
-Increased kidney perfusion
-Increased BP
-Increased CO
-Increased workload on heart |
|
|
Term
| type of insulin with pumps |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
High Fiber
Calories from
-1st: complex carbs
-2nd: Fats
-3rd: Proteins (10-20%) |
|
|
Term
|
Definition
Screen at 24-28 weeks
@risk: at first visit |
|
|
Term
|
Definition
1. Insulin Resistance
2. Abdominal obesity (>40)
3. Decreased HDL's
4. Increased triglycerides
5. HTN
6. CAD |
|
|
Term
| Hold ______ for 48 hours post cath on a diabetic pt |
|
Definition
Glucophage (Metformin)
-worried about kidneys |
|
|
Term
| Assess distal extremity post cath |
|
Definition
5p's
1. pain
2.pallor
3. paresthesia
4. paralysness
5. pulselessness
-skin temp
-cap refill |
|
|
Term
| #1 Sign of an MI in the elderly |
|
Definition
|
|
Term
| Untreated arrhthmias that can lead to sudden death post MI |
|
Definition
-bradycardia
-pulseless vtach
-vfib
-asystole |
|
|
Term
| Anti-arrhthmia drug to prevent 2nd episode of vfib |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Improtant side effect of amiodarone |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
end -ase
-Streptokinase
-Alteplase
-TNKase
-Reteplase
(w/in 6-8 hours of pain)
-no abgs |
|
|
Term
|
Definition
-soft toothbrush
-electric razor
-no IM's
watch for
-bleeding gums
-hematuria
-black stools |
|
|
Term
| Drugs needing bleeding precautions |
|
Definition
-Lovenox
-Coumadin
-Heparin
-Reapro
-Integrillin |
|
|
Term
|
Definition
|
|
Term
| Left Main Artery Occlusion |
|
Definition
**sudden death**
"Widow Maker" |
|
|
Term
|
Definition
-weight gain
-ankle edema
-SOB
-confusion |
|
|
Term
| ______ -> pulmonary HTN -> rt sided heart failure |
|
Definition
|
|
Term
| Sensitive indicator of HF |
|
Definition
BNP
(turn of Natrecor 2hrs prior) |
|
|
Term
|
Definition
|
|
Term
| s/s of Dig Toxicity (early vs. late) |
|
Definition
Early: Anorexia, N/V
Late: Arrthmias & vision changes |
|
|
Term
|
Definition
Ace Inhibitors (monitor for hyperkalemia)
then ARBS
-make give if dry cough with ace inhibitors |
|
|
Term
|
Definition
1. Find cause & stop
2. Atropine x1
3. Pacemaker |
|
|
Term
| Hallmark sign of artery problem |
|
Definition
| Intermittend Claudication |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Hallmark sign of Cardiac Tamponade |
|
Definition
| Increased CVP with decreased BP |
|
|
Term
| Watch ____ w/ Dig toxicity |
|
Definition
|
|
Term
| Before administration of dig |
|
Definition
Check apical pulse
(5th intercostal space, left midclavicular) |
|
|
Term
| Hemolytic Transfusion Reaction S/S |
|
Definition
-kidney pain
-hematuria
-cyanosis |
|
|
Term
| Which Lab finding should the nurse expect in FVD? |
|
Definition
| Increased specific gravity (>1.030) |
|
|
Term
| Aldactone makes you retain |
|
Definition
|
|
Term
| Electrolytes with inverse relationships |
|
Definition
1. Na & K
2. Ca & Phosphorus |
|
|
Term
| Insulin carries ___ & ___ into the cell |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
decreases serum Ca
(drives it back in the bone_ |
|
|
Term
|
Definition
Increases serum Ca
(excreted by the parathyroid) |
|
|
Term
| Mag toxicity overdose drug |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| potassium sparing diuretic |
|
|
Term
|
Definition
Fludrocortisone
& daily wts (w/in 2-3lbs) |
|
|
Term
|
Definition
1. change your mood
2. Immunosuppressed
3. Breakdown fat & proteins
4. Inhibit insulin |
|
|
Term
| Lab work to ensure proper nutrition & nitrogen balance |
|
Definition
-total protein
-albumin
-pre albumin (most sensitive) |
|
|
Term
| Two nutritional needs w/ burn victims |
|
Definition
|
|
Term
| Early s/s of gastric cancer |
|
Definition
| Abdominal discomfort relieved by antacids |
|
|
Term
| Ways to avoid bone marrow suppression w/ chemo |
|
Definition
| avoid aspirin (including alka-seltzer) |
|
|
Term
|
Definition
Should be serosanguineous
-contact physician if clear, colorless, bile-tinged drainage or frank bleeding occurs |
|
|
Term
|
Definition
|
|
Term
|
Definition
Dx of Pernicious Anemia
(measures the urinary excretion of Vit B-12) |
|
|
Term
| Gastrectomy Post-Op position |
|
Definition
|
|
Term
| Drugs used for bladder spasms |
|
Definition
-B&O suppository
-Oxybutynin (Ditropan) |
|
|
Term
|
Definition
| Increased w/ bone metastasis |
|
|
Term
| PSA (Prostate Specific Antigen) normal range |
|
Definition
|
|
Term
|
Definition
| Chest tubes/surgical side up |
|
|
Term
|
Definition
-Night sweats
-Dyspnea
-Hemoptysis |
|
|
Term
|
Definition
-Decreased Na
-Decreased Protein |
|
|
Term
|
Definition
-Antacids, Diuretics, Vitamins
-No more alcohol
-I & O, daily wts
-Rest
-Prevent bleeding
-Paracentesis
-Avoid narcotics |
|
|
Term
|
Definition
-Mental changes/ motor problems
-Difficulty to awake
-Asterexis (flapping arms, tremor)
-Decreased reflexes
-Fast EEG
-Fector (sweet, musty breath)
-GI bleeder |
|
|
Term
|
Definition
-Lactulose
-Cleansing enema
-Decreased protein diet
-Monitor serum ammonia |
|
|
Term
| Bleeding esophageal varices caused by |
|
Definition
|
|
Term
|
Definition
| Usually an esophageal varices |
|
|
Term
|
Definition
| Decreased BP in the liver (causes vasoconstriction) |
|
|
Term
| Bleeding Esophageal Varices Tx |
|
Definition
-Replace blood
-VS, CVP, Oxygen
-Sandostatin
-Sengstaken-Blakemore tube
-Cleansing enema
-Lactulose |
|
|
Term
|
Definition
-NPO pre
-Sedated
-NPO unti gag reflex |
|
|
Term
|
Definition
-Looks at esophagus & stomach w/ dye
-NPO past midnight
-No smoking, chewing, gym, mints
-Remove nicotine patch |
|
|
Term
|
Definition
1. Antacids
2. Proton Pump Inhibitors (Prilosec, Prevacid)
3. H2 Antagonist (Zantac, Pepcid)
4. ABX H. pylori
5. Sucralfate |
|
|
Term
| Client teaching Peptic Ulcer |
|
Definition
-Decrease stress
-Stop smoking
-Avoid caffeine
-Avoid spicy food
-Need to follow up for a year |
|
|
Term
|
Definition
Who?: Laboring/malnourished
Pain usually 30mins/ 1 hr after meals
-Food does not help
-Vomiting blood |
|
|
Term
|
Definition
Who?: executives, well nourished
-Night time pain & 2-3 hours after meals
-Food helps
-Black stool |
|
|
Term
|
Definition
Hole in diaphragm too large & stomach moves up to thoracic cavity
-congenital
-surgery
-trauma
-big tummy |
|
|
Term
|
Definition
-small, frequent meals
-sit up 1hour after meals
-Increased HOB
-Surgery
-Life style changes & healthy diet |
|
|
Term
| At Risk for Dumping Syndrome |
|
Definition
Secondary to:
-Gastric bypass
-Gastrectomy
-Gall bladder disease |
|
|
Term
|
Definition
-Semi Recumbent w/ meals
-Lie down on left side after meals
-No fluids w/ meals
-Decreased carbs |
|
|
Term
|
Definition
| Ulcerative inflammation bowel disease in large intestines |
|
|
Term
|
Definition
"Regional Enteritis"
-Inflammation & erosion of the illeum (small intestines)
-Can be anywhere |
|
|
Term
|
Definition
|
|
Term
| Dx of Crohn's/ Ulcerative Colitis |
|
Definition
|
|
Term
|
Definition
-Clear liquid diet 12-24 hours
-NPO 6-8hours
-Avoid NSAID's
-Laxative/enema until clear
-Go-Lytely (mix-ice cold)
-No straw
-Sedated
-Post-op: watch for perforation |
|
|
Term
| Diet Ulcerative Colitis & Crohn's |
|
Definition
-Decreased fiber
-Avoid hot/cold foods
-Antidiarrheals
-ABX
-Steroids |
|
|
Term
| Surgery Ulcerative Colitis |
|
Definition
| Total Colectomy (ilesostomy formed) |
|
|
Term
|
Definition
Try to avoid
-Remove affected area |
|
|
Term
|
Definition
| Has a nipple valve that opens & closes to empty |
|
|
Term
|
Definition
| Removes colon & attaches to ileum to the rectum |
|
|
Term
|
Definition
-Avoid foods hard to digest
-Gatorade
-At risk for kidney stones |
|
|
Term
| Which Colostomies do we irrigate? |
|
Definition
-Descending
-Sigmoid
-Same time every day
-After a meal |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Appendicitis Client waiting for surgery position |
|
Definition
| Lay on right side w/ head elevated |
|
|
Term
|
Definition
|
|
Term
| Any major abdominal surgery post-op position |
|
Definition
|
|
Term
|
Definition
-Keep refridgerated -> leave out
-Central line/PICC
-Dedicated line
-D/C gradually
-Daily wt's
-May take insulin
-Finger stick q 6 hours
-Change tubing w/ each new bag
-Check urine for glucose & ketones
-Hung for 24 hours only
-On pump
-Do not mix ahead of time |
|
|
Term
|
Definition
Norm: 120-160
Worried: 110-120
Panic: <110 |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How fetal position/presentation determined? |
|
Definition
| Lepold Maneuver (void first, btwn contractions) |
|
|
Term
|
Definition
- 2 weeks prior to term
-Head descends into pelvis |
|
|
Term
|
Definition
| Largest presenting part is in the pelvic inlet |
|
|
Term
|
Definition
-Measured in cm
-Relationship btwn the presenting part of the fetus to the ischial spine of mom |
|
|
Term
| When should full term prego mom report to hospital? |
|
Definition
-Contractions are 5 mins apart
-Water broke |
|
|
Term
|
Definition
-Want REACTIVE
-Want 2 or more accelerations of 15 beats w/fetal movement
(Lasting 15 seconds for 20 mins) |
|
|
Term
| BPP (Biophysical Profile) Ultrasound |
|
Definition
1. HR (NST reactive)
2. Muscle tone (1 flex)
3. Movement (3x)
4. Breathing (1x)
5. Amni Fluid
30mins
10/10 great
-6 worry
-Under 4: ominous |
|
|
Term
| Contraction Stress Test (Oxytocin Challenge) |
|
Definition
-Want negative
-Done when NST is non-reactive or w/ high risk
-Done after 28 weeks
-Induce contractions, look for decelerations |
|
|
Term
|
Definition
| Benign- caused by physiological hypoxia of fetal head compression |
|
|
Term
|
Definition
| BAD- Uteroplacental insufficency |
|
|
Term
|
Definition
|
|
Term
|
Definition
Position: Left side, leg flexed
Stage 1: 3-4 cm dialted
NO HA
HYPOTENSION IS A CONCERN
-bolus w/ 1000ml of NS or LR before
Then put in semi fowlers |
|
|
Term
|
Definition
One-on-one care
-Watch for hypertonic labor, fetal distress, uterine rupture
-Piggyback
-Position: any except flat on back |
|
|
Term
|
Definition
-If contractions too often
-Last too long
-Any fetal distress
-Late decelerations |
|
|
Term
| Type of Contractions want w/ Pitocin |
|
Definition
| 1 q 2-3 mins lasting 60 seconds |
|
|
Term
|
Definition
-Temp: up to 100.4 (1st 4 hours)
-BP: stable
-HR: 50 to 70 (for 6 to 10 days) |
|
|
Term
|
Definition
Rubra: 3-4 days
Serosa: 4-10 days
Alba: 10-28 days
NO CLOTS > nickle size |
|
|
Term
| Breast feeding mom nutrition/ fluids |
|
Definition
-Increase calories by 500
-8-10 8oz glasses/day |
|
|
Term
| Early post-partum Hemorrhage |
|
Definition
| 500cc blood loss w/ in 24hours & 10% decrease in hematocrit |
|
|
Term
|
Definition
-Done at 1 & 5 mins
-Want 8 to 10 |
|
|
Term
|
Definition
| Given to eyes to prevent Gonorhea and Chlamydia |
|
|
Term
| Phytonadione (Aquamephyton) |
|
Definition
| Vit K to promote clotting factor |
|
|
Term
|
Definition
1st 24 hours
Usually Rh/ABO incompat |
|
|
Term
|
Definition
After 24hours
Hemolysis of excess RBC's or Liver immaturity |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Done on mom to determine # of antibodies in blood |
|
|
Term
|
Definition
| Done on baby to determine if any antibodies are stuck to RBC's |
|
|
Term
| Tx for Rh+ fetus and sensitized mom |
|
Definition
1. Frequent ultrasound
2. Early birth |
|
|
Term
|
Definition
-At 28 weeks
-72hrs after (for next baby) |
|
|
Term
|
Definition
| must be given before antibodies are formed |
|
|
Term
| Presumptive Signs of Pregnancy |
|
Definition
-Frequency
-Amenhorrhea
-N/V
-Breast tenderness |
|
|
Term
| Probable Signs of Pregnancy |
|
Definition
-+ prego test
-Goodell's sign
-Chadwick's sign
-Hegar's sign
-Uterine Enlargement
-Braxton Hick
-Pigmentation Change |
|
|
Term
|
Definition
-Softening of Cervix
-2nd month |
|
|
Term
|
Definition
| -Bluish color of vaginal mucosa (week 4) |
|
|
Term
|
Definition
| -Softening of lower uterine segment (2nd & 3rd month) |
|
|
Term
| Positive Sign of Pregnancy |
|
Definition
-Fetal HR beat
-Doppler: 10-12 weeks
-Fetoscope: 17-20 weeks
-Fetal movement
-Ultrasound |
|
|
Term
|
Definition
|
|
Term
|
Definition
| # of pregnancy reaches 20 wks |
|
|
Term
|
Definition
|
|
Term
|
Definition
T= term
P= Preterm
A= Abortion
L= Living |
|
|
Term
|
Definition
-1st day of LMP
-Add 7 days
-Subtract 3 months
-Add 1 year |
|
|
Term
|
Definition
-After 1st trimester: increased calories by 300/day (500 w/adolescents)
-Protein to 60g/day |
|
|
Term
| Weight gain 1st trimester |
|
Definition
|
|
Term
|
Definition
Iron: take w/ Vitamin C
Folic Acid: prevent neural tube defects (400mcg/day) |
|
|
Term
|
Definition
| Do NOT let HR get > 140bpm (decreased CO & decreased uterine perfusion) |
|
|
Term
| Pregnancy Physician Visits |
|
Definition
1st 28 weeks: 1 month
28-36weeks: Q 2 weeks
36weeks: weekly |
|
|
Term
|
Definition
|
|
Term
| Chest tube in 2nd intercostal space |
|
Definition
|
|
Term
| Chest tube in 8th or 9th Intercostal space |
|
Definition
| Remove fluid and drainage |
|
|
Term
| Water seal chamber of chest tube purpose |
|
Definition
|
|
Term
| Bubbling in water seal chamber |
|
Definition
| Normal when client coughs, sneezes, or exhales |
|
|
Term
|
Definition
| Rise and fall of water in the water seal chamber when client breathes |
|
|
Term
| ___ ml of drainage or greater in the 1st hr of chest tube placement report to physician |
|
Definition
|
|
Term
|
Definition
-Keep below chest level
-Keep tubing straight and free of kinks
-Tape connections
-Go w/ client if transferred |
|
|
Term
| Chest tube accidentally pulled out of pt? |
|
Definition
| Sterile vaseline gauze taped down on 3 sides |
|
|
Term
| When is bubbling a problem? |
|
Definition
| Continuous bubbling in water seal chamber |
|
|
Term
| Chest tube removal pt instructions |
|
Definition
| Instruct client fo deep breath & hold or valsalva |
|
|
Term
|
Definition
-Large bore needle 2nd ICS
-Cause
-Chest tube |
|
|
Term
|
Definition
-Flail Chest
-Pulmonary edema
-Severe hypoxia
-ARDS |
|
|
Term
|
Definition
Tx: COPD, heart failure, & sleep apnea
(must be able to cooperate & breathe spont) |
|
|
Term
|
Definition
|
|
Term
| Priority NSG assessment w/ PEEP, CPAP, or BiPAP |
|
Definition
| Bilateral lung sounds q 2 hours (worry about pneumothorax) |
|
|
Term
|
Definition
-Dehydrated
-Prolonged immobility
-BC pills
-Clotting disorder
-A-fib |
|
|
Term
|
Definition
-Hypoxemia (#1)
-Decreased Po2
-SOB, Cough, Increased RR & HR
-Sharp stabbing chest pain
-Increased D dimer
-+VX scan
-+spiral CT/ CT angio |
|
|
Term
| Post-op Client w/ suspected PE |
|
Definition
D-dimer will be positive
Use VQ scan |
|
|
Term
|
Definition
-Prevent (hydrate & ambulate)
-O2
-ABG's
-Ventilator
-Decreased pain
-Heparin
-Lovenox
-Warfarin |
|
|
Term
|
Definition
-Pulse
-Color
-Movements
-Sensation
-Cap refill
-Temp |
|
|
Term
|
Definition
-Long bone
-Pelvic
-Crushing |
|
|
Term
|
Definition
-Petechia/Rash over chest
-Conjunctival hemorrhage
-Snow storm on CXR "patchy inflitrates" |
|
|
Term
|
Definition
-Young males
-First 36hours of injury |
|
|
Term
|
Definition
-Elevate extremity
-Soft cast -> Rigid
-Loosen cast (be careful to remove)
-Fasciotomy |
|
|
Term
|
Definition
| Deformity at fracture site |
|
|
Term
|
Definition
-Ice packs on the side for first 24hours
-Use palms first 24hours
-Keep uncovered (air dry)
-Rest on soft pillow
-Mark break through bleeding (circle, date, time) |
|
|
Term
|
Definition
-Neurovascular check
-Elevate, cold packs, analgesics
-Reassess in 30mins |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Steinman pins
-Crutchfield
-Gardner-Wells tongs
-Halo vest |
|
|
Term
| Post-op Total Hip replacement |
|
Definition
-Neutral rotation
-Want abduction
-Want extension |
|
|
Term
| Purpose of trochanter roll |
|
Definition
| Prevent external rotation |
|
|
Term
| Complications of Hip Replacement |
|
Definition
1. Dislocation (shortening of leg, can't move, pain, abnormal rotation)
2. Infection (proph ABX, remove drains asap)
3. Vascular Necrosis
4. Immobility problems |
|
|
Term
| Client Education Total Hip |
|
Definition
1. Walk
2. Avoid flexion
-no low chairs
-no travel long distances
-no sit >30mins
-no lifting heavy objects
-no stair climbing
-no bending at waist |
|
|
Term
| Below knee amputation position |
|
Definition
|
|
Term
| Elevate post op amputation |
|
Definition
-controversial
-only w/ order
-only w/ foot of bed (not w/ pillow) |
|
|
Term
| Prevent hip/knee contractures |
|
Definition
|
|
Term
| S/S that spinal shock persist |
|
Definition
|
|
Term
|
Definition
-aphasic
-weakness face & tongue
-weakness on rt side of body |
|
|
Term
|
Definition
| impaired voluntary movement |
|
|
Term
|
Definition
| decreases the effectiveness of bc pills w/ dilantin |
|
|
Term
|
Definition
-Resp depression
-Drowsiness
-Decreased BP
-Constipation
-Urinary retention
-N/V
-Tremors |
|
|
Term
| Dilantin Therapeutic Level |
|
Definition
10-20
>20: nystagmus
>30: ataxia, slurred speech |
|
|
Term
|
Definition
|
|
Term
|
Definition
-hyperinflated chest
-decreased 02 sat w/ mild excercise |
|
|
Term
| Primary purpose of pursed lip breathing |
|
Definition
|
|
Term
|
Definition
-Doll's eye
-want present
eye move opposite when head is turned |
|
|
Term
|
Definition
50ml cool H20
Turn on side |
|
|
Term
|
Definition
|
|
Term
|
Definition
-w/ or w/out dye
-consent
-keep head still
-no talking |
|
|
Term
|
Definition
-Magnet used
-No jewelry
-No pacemakers
-Some old tats will need to be looked at
-Thumping noise |
|
|
Term
|
Definition
-femoral artery
Pre: well hydrate, allergies
Post: bed rest 4-6hours
Major complication: embolus |
|
|
Term
|
Definition
DX: Seizure or brain death
Pre: no sedatives, no caffeine, no npo
During: baseline then cough/hypervent |
|
|
Term
|
Definition
3rd/4th lumbar
Position: propped up/ fetal
complications: Meningitis (+Kernig & Brudzinski)
Post: Flat/prone 2-3 hrs & increase fluids |
|
|
Term
|
Definition
+ in meningitis
when client's hips are flexed 90 degress, extending the knee causes pain |
|
|
Term
|
Definition
+ in meningitis
flexing clients neck cause flex of hips/knee |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Difficulty awakening
-Difficulty speaking
-Confusion
-Severe headache
-Vomiting
-Pulse changes
-Unequal pupils |
|
|
Term
|
Definition
-Loss of consciousness-> awake -> neuro change
*emergency*
tx: burr holes |
|
|
Term
|
Definition
-Above T6 Spinal Cord Injury
-Increased BP, decreased HR, HA, nasal stuffiness, flushing, sweating, blurred vision
Tx: sit up, urinary catheter
Cause: distended bladder, constipation, stimuli |
|
|
Term
|
Definition
|
|
Term
| Client emerges from coma if combative |
|
Definition
| NO RESTRAINTS (increases ICP) |
|
|
Term
|
Definition
-Arched spine
-Plantar flexion
*worst* |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Mannitol
-Lasix
-Dexamethasone
-Hyperventilate (temp)
-Decrease PCO2
-Temp <100.4
-Avoid restraints, valsalva
-Decrease suctioning, coughing
-Phenobarbital
-Elevate HOB (mid)
-Limit fluids to 1200-1500ml/day |
|
|
Term
| Watch for ____ & ___ with increased ICP |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
AID's client: >5mm
Non-AID's: >10mm |
|
|
Term
|
Definition
Opportunistic Respiratory Infection
-fever
-dyspnea
-cough
-wt loss |
|
|
Term
| Pulmonary Sarcoidosis Early S/S |
|
Definition
|
|
Term
| First manifestation of TB |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
Direct (conjugated) 0-0.3 mg/dL
Indirect (unconjugated) 0.1-1 mg/dL
Total: lower than 1.5 mg/dL |
|
|
Term
|
Definition
|
|
Term
|
Definition
Non-diabetic: 4-5.9%
Good diabetic control: <7%
Fail Diabetic control: 7-8%
Poor Diabetic control: >8% |
|
|
Term
|
Definition
Female: 12-15 g/ dL
Male: 14-16.5 g/ dL |
|
|
Term
|
Definition
Female: 35-47%
Male: 42-52% |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
standard warfarin thearpy: 2-3
high-dose warfarin: 3-4.5 |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| hCG levels (worry when decrease) |
|
|
Term
|
Definition
-Bedrest & Pelvic Rest (no sex)
-If miscarriage imminent (IV, blood, D&C) |
|
|
Term
|
Definition
Benign, neoplasm (grape-like clusters of vesicles)
why?: uterus enlarges too fast |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Small mole (D&C)
-Do not get pregnant for a year
-CXR for possible metastasis
-Will measure hCG levels weekly until normal, rechecked q 2-4weeks, then every 1-2months for 6months to a year |
|
|
Term
|
Definition
| Malignant hydatidiform mole |
|
|
Term
|
Definition
|
|
Term
| First s/s of ectopic pregnancy? |
|
Definition
pain
(usually s/s of pregnancy then pain, spotting, or may be bleeding into the peritoneum.)
*if the fallopian tube ruptures, vaginal bleeding may occur |
|
|
Term
|
Definition
1. Methotrexate
2. If does not stop the growth of the embryo, the tube will be removed laproscopic (if it has not ruptured)
3. If the tube ruptures, it will be removed via a laparotomy |
|
|
Term
| If a fallopian tube ruptures during an ectopic pregnancy, concerned about? |
|
Definition
|
|
Term
| Most common cause of bleeding in the later months (usually the 7th) |
|
Definition
| Placenta previa (painless bleeding) |
|
|
Term
| Placenta previa definition |
|
Definition
| the placenta has implanted wrong |
|
|
Term
|
Definition
-may be hospitalized with complete previa from 32weeks
-bedrest
-rule out abruption
-pad counts
-monitor blood count and baby closely
-monitor for contractions (call MD)
-NO VAGINAL EXAMS |
|
|
Term
| Type of Delivery with placenta previa |
|
Definition
|
|
Term
| Fetal complications of placenta previa |
|
Definition
-preterm delivery
-intrauterine grown restrictions
-fetal distress
-anemia |
|
|
Term
| Maternal complications of placenta previa |
|
Definition
-Hemorrhage
-Potential D&C risk |
|
|
Term
| Is the placenta implanted normal in abruptio placenta? |
|
Definition
|
|
Term
| Abruptio Placenta definition |
|
Definition
| the placenta separates prematurely (mva, domestic violence, previous c-section, membranes rupture, associated with cocaine/PIH/smoking) |
|
|
Term
|
Definition
-Rigid board like abdomen (w/ or w/out vaginal bleeding)
-Abdominal pain w/ increased uterine tone
-Difficult to palpate fetus |
|
|
Term
| Tx with abruptio placenta |
|
Definition
|
|
Term
| Two priorities w/ abruptio placenta |
|
Definition
-Manage fetal status
-manage maternal shock |
|
|
Term
|
Definition
| -When the cervix dilates prematurely around the 4th month of pregnancy resulting in repeated 2nd trimester miscarriages |
|
|
Term
|
Definition
-Cerclage (purse-string suture) at 14-18 weeks
-C-section or physician will clip |
|
|
Term
|
Definition
-Starts like morning sicknes (excessive vomiting -> dehydration -> starvation -> death)
Due to high levels of estrogen and hCG |
|
|
Term
| s/s Hyperemesis Gravidarum |
|
Definition
-decreased BP
-increased H & H
-decreased UO
-decreased potassium (from vomiting)
-decreased weight
-urine positive for ketones |
|
|
Term
| tx Hyperemesis Gravidarum |
|
Definition
-NPO for 48hours
-IVF's 3000 ml for 1st 24hours
-Antiemetic
-Vitamins
-Quiet, calm environment
-Oral hygiene
-6-8 small, dry feedings followed by clear liquids
-Foods/liquids should be icy cold or hot
-well ventilated room |
|
|
Term
|
Definition
| increased BP, proteinuria, edema after 20wks |
|
|
Term
|
Definition
-sudden wt gain
-face & hands swollen
-headache
-blurred vision, seeing spots
-hyper-reflexia (increased DTR's)
-clonus -> seizures |
|
|
Term
| when pregnant client gain 2 or more pounds in a week |
|
Definition
| worry about Pregnancy induced hypertension |
|
|
Term
|
Definition
-BP 30/15 off their baseline documented 6 hours apart
-No baseline: 130/90 |
|
|
Term
|
Definition
| BP elevated to 160/110 documented 6 hours apart |
|
|
Term
|
Definition
-Bedrest
-Increase protein in diet |
|
|
Term
|
Definition
-Sedation to delay seizures
-Magnesium Sulfate (Drug of Choice)
-Valium |
|
|
Term
| Magnesium Sulfate three properties |
|
Definition
| anticonvulsant, sedative, vasodilator |
|
|
Term
| Positioning of pregnant client |
|
Definition
NEVER ON BACK
-put on side (usually left) |
|
|
Term
| Client is at risk for _________ while on Magnesium Sulfate |
|
Definition
|
|
Term
| Nursing action for a client receiving Magnesium |
|
Definition
-Check for mag toxicity q 1-2hours (by checking DTR's, BP, respiration, and LOC)
-UO monitored hourly
-Serum mag checked periodically |
|
|
Term
|
Definition
|
|
Term
| If diastolic is >100 in pre-eclampsia pt, give ____ & _____ |
|
Definition
Apresoline & magnesium sulfate
(watch for tachycardia) |
|
|
Term
| After a preeclampsia client delivers, assess for ______ for 48hours |
|
Definition
|
|
Term
| NSG care for preeclampsia |
|
Definition
-Single room
-Very quiet environment
-Dim the lights, no TV
(decrease stimuli) |
|
|
Term
| Additional tx for preeclampsia mom |
|
Definition
| Steroids (Betamethasone) at 24 to 34 weeks to increase the production of surfactant |
|
|
Term
| Turning point from preeclampsia to eclampsia |
|
Definition
|
|
Term
|
Definition
-Monitor FHTs
-Watch for labor
-Watch for heart failure
-Monitor for: HF, stroke, MI, renal failure, DIC, HELLP syndrome, neurological damage, MODS |
|
|
Term
|
Definition
| occurs after 20weeks, proteinuria |
|
|
Term
|
Definition
| occurs after 20weeks, no proteinuria |
|
|
Term
| Chronic Hypertension (in the pregnancy client) |
|
Definition
| Client with HTN before pregnancy |
|
|
Term
| Chronic Hypertension w/ superimposed PIH |
|
Definition
| HTN prior to pregnancy & the HTN got worse w/ developing proteinuria after 20 weeks |
|
|
Term
|
Definition
| labor that occurs btwn 20-37weeks |
|
|
Term
|
Definition
-Tocolytic (Terbutaline) se: increased pulse & hyperactivity
-Mg Sulfate
-Betamethasone (IM to stimulate maturation of lungs)
-Usually can be fixed with hydration and by treating vaginal infections or UTI's |
|
|
Term
|
Definition
-Lift head off cord until DR arrives
-Trendelenburg or Knee chest position
-Admin oxygen
-Monitor fetal heart tones |
|
|
Term
| Risk to Fetus w/ Shoulder Dystocia |
|
Definition
-Hypoxia (leads to cerebral palsy & asphyxia)
-Brachial plexus injury (leading to Erb's palsy)
-Broken clavical
-Bell's palsy
*many caused from forcep use*
(some resolve, but can lead to permanent damage) |
|
|
Term
| Maternal Risk w/ shoulder dystocia |
|
Definition
-Traumatic delivery leading to permanent damage
-Bruised bladder
-Extension of episiotomy
-Rectal tear
-Torn cervix and/or uterus |
|
|
Term
| At Risk for Shoulder Dystocia |
|
Definition
-LGA/ Macrosomic baby (>4000 grams)
-Gestational diabetes
-Previous hx of shoulder dystocia
-Post date delivery (larger fetus) |
|
|
Term
| NSG care for shoulder dystocia |
|
Definition
-McRobert's Maneuver
-Mazzanti technique (never apply super pubic pressure, only a doctor can) |
|
|
Term
| Leading cause of neonatal morbidity |
|
Definition
| Group B Streptococcus (GBS) |
|
|
Term
| Risk for fetus acquiring GBS |
|
Definition
| If membranes rupture or during a vaginal delivery |
|
|
Term
| Teaching to mother with GBS |
|
Definition
| Not a sexually transmitted disease |
|
|
Term
| Risk Factors for Neonatal GBS |
|
Definition
-Preterm birth less than 37 weeks
-+prenatal cultures
-premature rupture of membranes (longer than 18hr)
-positive history for early-onset neonatal GBS
-Intrapartum maternal fever higher than 100.4F
-previous infant w/ GBS |
|
|
Term
|
Definition
| Prophylactic ABX therapy (Penicillin) |
|
|
Term
| Order of Obtaining Vital Signs on a Child |
|
Definition
1. Respirations
2. HR
3. BP
4. Temp |
|
|
Term
| Rectal Temp in Pediatrics |
|
Definition
|
|
Term
|
Definition
| All ages if Oral is unavailable |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What happens to growth rate between 6 and 12 years? |
|
Definition
|
|
Term
| How much early do girls experience onset of adolescence? |
|
Definition
|
|
Term
| Nutritional Assessment on Peds Lab Values |
|
Definition
1. Hemoglobin/hematocrit
2. Albumin
3. Creatitine
4. Nitrogen |
|
|
Term
|
Definition
CRIES
C- Crying
R- Requires increased oxygen
I- Increased vital signs
E- Expression
S- Sleeplessness
Scale 0-10 |
|
|
Term
|
Definition
Pain scale 2-7years
Face, Legs, Activity Crying, Consolability
Scale 0-10 |
|
|
Term
|
Definition
Any age (usually greater than 3 years)
-make sure has cognitive development and is not developmentally delayed
-Scale is 0-5 |
|
|
Term
| Numerical Pain Scale & Peds |
|
Definition
|
|
Term
|
Definition
-Most common type of Croup
-Primarily affects Children under 5 |
|
|
Term
| Laryngotracheobronchitis cause |
|
Definition
(Croup)
-Parainfluenza
-Adenovirus
-RSV |
|
|
Term
|
Definition
-Treat at home: steam from hot shower, cool mist humidifiers, car rides with windows down at night
-Severe: corticosteroids |
|
|
Term
|
Definition
| H. Influenza (usually vaccined against) |
|
|
Term
|
Definition
-Absence of a cough
-Drooling
-Agitation w/ rapid progression to severe respiratory distress
**Emergency** |
|
|
Term
|
Definition
EMERGENCY
-May require intubation or trache
-IV antibiotics and corticosteroids |
|
|
Term
|
Definition
|
|
Term
| Tonsilectomy Post op Positioning |
|
Definition
-Place on side w/ elevated HOB
-Prone |
|
|
Term
|
Definition
-No brown/red liquids
-Hemorrhage= frequent swallowing
-At risk for hemorrhage: up to 10 days post op
-Complaint post op: sore throat and painful ear
-Low grade temp
-Bad breath (from old blood) |
|
|
Term
|
Definition
-Middle ear is affected
-Eustacian tubes are blocked
-Usually follows an upper respiratory infection |
|
|
Term
|
Definition
-Heating pads
-Avoid chewing (soft foods)
-Lie on effected side
-May have hearing impairment
-Avoid smoke
-May require PE tubes |
|
|
Term
|
Definition
The ear tubes stay in for about 6 months and then falls out.
-Not an emergency when falls out, but should contact physician to let them know |
|
|
Term
| Prevention of Otitis Media |
|
Definition
-W/ PE tubes: wear ear plugs while swimming/bathing
-Feed babies upright
-No bottle proping
-Gentle nose blowing
-Avoid smoke |
|
|
Term
|
Definition
| Acute viral infection that affects the bronchioles and is caused by RSV bronchiolitis or RSV pneumonia |
|
|
Term
| Leading cause of Lower Respiratory Tract Illness in children less than 2 years |
|
Definition
|
|
Term
|
Definition
-Prematurity
-Congenital disorders
-Smoke
-Focus on prevention (high risk need vaccine) |
|
|
Term
|
Definition
| S/S can range from mild to severe (from cough,runny nose w/ copious amount of mucous to severe respiratory distress) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Contact precautions (teach good hand washing) |
|
|
Term
|
Definition
-Oxygen (may need ventilation)
-IV fluids
-Suction
-Antipyretics
-Antiviral (Ribavirin) (through aresol) |
|
|
Term
|
Definition
-RSV
-adenovirus
-parainfluenza |
|
|
Term
| Bacterial Pneumonia Cause |
|
Definition
| -Strep pneumonia (usually those >4years) |
|
|
Term
|
Definition
"walking pneumonia"
-caused by Myoplasm pneumonia
-primarily in adolescents |
|
|
Term
|
Definition
-Fine crackles or rhonchi
-Productive or nonproductive cough
-Abdominal distention
-Back pain
-Fever (usually high)
-Chest pain from coughing |
|
|
Term
|
Definition
-O2
-Fluids
-ABX
-Antipyretics
-Nebulizer
-Cough suppressants (usually @ night) |
|
|
Term
| What type of infection are Down syndrome kids most at risk for? |
|
Definition
| Respiratory (because of poor immune system)f |
|
|
Term
| Most common defect associated with Down's Syndrome? |
|
Definition
|
|
Term
|
Definition
| -Inherit trait (must get trait from BOTH parents) |
|
|
Term
|
Definition
-thick, sticky secretions
-characterized by exocrine gland dysfunction
-thick, sticky secretions found in the lungs and GI tract |
|
|
Term
| Dx test for cystic fibrosis |
|
Definition
| Positive sweat chloride test (why these clients are at risk for hyponatremia) |
|
|
Term
| Earliest sign in the newborn w/ cystic fibrosis |
|
Definition
|
|
Term
| Type of stools w/ cystic fibrosis |
|
Definition
|
|
Term
|
Definition
-Pancreatic enzymes 30mins prior to eating (do not crush or chew)
-Need well balanced, low fat, high calorie, high protein diet (require 150% of the recommended daily allowance)
-Take water soluble vitamins (Vit A, D, E, & K) |
|
|
Term
| Heart failure cause in pediatric clients |
|
Definition
| usually congenital defects |
|
|
Term
| s/s of heart failure in pediatrics |
|
Definition
-Lips turn blue when taking a bottle (first sign)
-Increased pulse at rest or w/ slight exertion
-Increased RR
-Scalp sweating in infants
-Fatigue
-Sudden weight gain |
|
|
Term
| tx of heart failure in pediatrics |
|
Definition
-Ongoing assessment (lung sounds)
-Control room temperature (increased temp=increased workload on heart)
-Sit them up
-Rest a lot
-Decrease stimuli
-Cool, humidified oxygen
-Uninterrupted sleep |
|
|
Term
| Fluid retention think _______ problems first |
|
Definition
|
|
Term
| Digoxin in Pediatric Clients |
|
Definition
-Infants rarely get 1mL
-Give 1hr before and 2hr after feedings
-DO NOT mix w/ medicine, food, or fluid
-Always check the dose w/ another nurse
-Check the apical pulse for 1 full minute |
|
|
Term
| Ace Inhibitors Side Effects & Action |
|
Definition
Action: block Aldosterone
-decreases BP
-Kidney problems
-Dry cough (stop, try another) |
|
|
Term
| Nutrition in HF Pediatric Clients |
|
Definition
-Well rested prior to eating (feed when wake up or show signs of hunger, decrease crying)
-Small, frequent feedings q 3 hours, no longer than 30mins
-High calories
-Soft nipple w/ a large opening
-May require gavage feedings
-Usually don't require Na & H2O restrictions because of decreased intake |
|
|
Term
|
Definition
| -An inflammatory disease that occurs after an infection with Group A beta hemolytic streptococcus |
|
|
Term
| Therapeutic Management of Rheumatic Fever |
|
Definition
| Penicilin G (if allergic, erythromycin) |
|
|
Term
|
Definition
| -Characterized by wide spread inflammation of the small and medium sized blood vessels (usually the coronary arteries) |
|
|
Term
|
Definition
-High dose IV immune-globulin
-Aspirin therapy
-Quiet environment |
|
|
Term
| Cleft Palate/Cleft Lip Feeding |
|
Definition
-Feed w/ longated nipple or medicine dropper down the side of the mouth
-Burp frequently so they will not allow a lot of air (air->abdominal distention ->vomiting->aspiration) |
|
|
Term
|
Definition
-Position on back or side lying (to protect the suture line)
-Do not place prone
-Clean the suture line w/ saline post op |
|
|
Term
| Cleft Palate Repair Post-op |
|
Definition
-Place prone (to promote drainage)
-Avoid putting things into their mouth (thermometers, straws)
-Soft diet until well healed
-Elbow restraints
**best to perform surgery before speech development** |
|
|
Term
| When does GER progress to GERD? |
|
Definition
| -Failure to thrive, bleeding, or difficulty swallowing (dysphagia) occurs |
|
|
Term
| Positioning infant w/ GER or GERD |
|
Definition
-Upright w/ feedings and at night
-30 degree elevated prone position to decrease reflux and improve stomach emptying |
|
|
Term
|
Definition
-Small frequent feedings of thickened formula
-Breast feeding continues w/ more frequent feedings or expressing the milk for thickening w/ rice cereal |
|
|
Term
|
Definition
| H2 blockers, Proton pump inhibitors |
|
|
Term
| Esophageal Atresia/T-E fistula |
|
Definition
-The saliva cannot make it to the stomach because the esophagus ends in a blind pouch
-No meconium passed at birth
-Fed through a gastrostomy tube |
|
|
Term
| Top Nursing Diagnosis w/ Esophageal Atresia |
|
Definition
|
|
Term
|
Definition
| -Surgery: infant is placed on their back w/ head & shoulder elevated |
|
|
Term
| Polyhydraminos in pregnancy is commonly seen in infants with |
|
Definition
| GI problems (aren't swallowing amniotic fluid) |
|
|
Term
|
Definition
-Projectile vomiting usually after eating
-Very hungry
-Olive shaped mass in the epigastric region
-Peristalsis is obvious
-Abdominal distention |
|
|
Term
|
Definition
-Hydration
-I & O
-Daily wts
-Monitor urine specific gravity
-Surgery |
|
|
Term
|
Definition
(Sudden onset)
-Cramping
-Abdominal Pain
-Inconsolability
-Drawing up the knees
-Currant jelly stools (maroon colored) |
|
|
Term
|
Definition
|
|
Term
|
Definition
"aganglionic megacolon"
-a congenital anomaly that results in a mechanical obstruction along the bowel (sigmoid) |
|
|
Term
| Hirschsprung's Disease s/s |
|
Definition
-constipation
-abdominal distention
-ribbon-like stools w/ a foul smell |
|
|
Term
| Hirschsprung's Disease tx |
|
Definition
| -Multiple surgeries to remove the portion of the bowel that is diseased |
|
|
Term
|
Definition
-No rectal opening (so no meconium passed)
-Surgery and a temp colostomy |
|
|
Term
|
Definition
Lifelong
-A genetic malabsorption disorder where there is a permanent intestinal intolerance to Gluten |
|
|
Term
|
Definition
No fluid w/ Gluten
NO BROW
-B (Barley)
-R (Rye)
-O (Oats)
-W (Wheats)
HAVE RCS
R- Rice
C- Corn
S- Soy |
|
|
Term
| Urine smells fishy in child |
|
Definition
|
|
Term
|
Definition
-Renal anomalies
-Constipation
-Bubble baths
-Poor hygiene
-Pin worms
-Sexual abuse |
|
|
Term
| Classic Symptoms in Children >2years w/ a UTI |
|
Definition
-Frequency
-Dysuria
-Fever
-Flank pain
-Hematuria |
|
|
Term
|
Definition
-Surgical emergency
-Painful condition caused by the sudden twisting of the spermatic cord which results in the loss of blood to the testicle
-Peak onset at 13 |
|
|
Term
| S/S of Testicular Torsion |
|
Definition
-Unilateral pain to the affected testicles
-Edema
-N/V
-Discoloration of the testicles |
|
|
Term
|
Definition
-Bed rest
-Hydration
-Analgesics
-ABX
-Blood transfusion
-Oxygen |
|
|
Term
| Leukemia Questions Think Of |
|
Definition
-Immunosuppression
-Thrombocytopenia
-Anemia |
|
|
Term
| Wilm's Tumor are found where? |
|
Definition
|
|
Term
| Wilm's Tumor most common presenting sign |
|
Definition
swelling or non-tender mass on one side of the abdomen
-don't palpate the abdomen
-general care while bath or moving the client |
|
|
Term
|
Definition
-Bulging of anterior fontanel
-Dilated scalp veins
-Depressed eyes
-Irritability and changes in the LOC
-High-pitched cry |
|
|
Term
|
Definition
-Insertion of a VP shunt
--measure the frontal occipital circumference
--fontanel & cranial suture line assessment
--monitor the temp
--supine position |
|
|
Term
|
Definition
-Limited to one side of the brain
-Simple: without loss of consciousness
-Complex: impaired consciousness |
|
|
Term
| How are pin worms spread? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Increased risk for severe varicella rx |
|
Definition
|
|
Term
|
Definition
| -Spleen will be enlarged (don't want them to participate in contact sports) |
|
|
Term
|
Definition
|
|
Term
| Impetigo Lesions are usually found on |
|
Definition
| -Usually located on mouth & nose but may be present on the hands and extremities |
|
|
Term
| Scabies tx w/ Lindane age factor |
|
Definition
| -Contraindicated for children under 2 years of age |
|
|
Term
| NSG Care for a Child who sustained a burn |
|
Definition
-Scarring is more severe in child vs. an adult
-A delay in growth may occur following a burn
-The higher proportion of body fluid to mass in a child increases the risk of infection for infants and young children
-Burn involving 10% or more of TBSA require fluid resuscitation |
|
|
Term
| To prevent too much iron consumption from multiple blood transfusion Chelation therapy & ______ are prescribed |
|
Definition
|
|
Term
| This disorder causes platelets to adhere to damaged endothelium |
|
Definition
|
|
Term
| What diagnostic study confirms the diagnosis of acute lymphoblastic leukemia |
|
Definition
|
|
Term
| Which dx test confirms Hodgkin's disease? |
|
Definition
| -The presence of Reed-sternburg cells in the lymph nodes |
|
|
Term
| Specific characteristics of Hodgkin's disease |
|
Definition
-Abdominal pain
-Painless, firm, and moveable adenopathy in the cervical area |
|
|
Term
| Ketone's in a child's urine w/ type 1 diabetes tx |
|
Definition
| Encourage the child to drink fluids |
|
|
Term
| Positive phenylalanine re-screening blood test |
|
Definition
|
|
Term
| IV fluid to treat Diabetic Ketoacidosis (initial tx) |
|
Definition
|
|
Term
| Child w/ intussusception stool characteristics |
|
Definition
| -Bright red blood and mucus in the stools |
|
|
Term
| Care plan for a child w/ hepatitis |
|
Definition
-Low fat, well-balanced diet
-Teach effective hand washing to the child
-Instruct parents to avoid medicines except those that are prescribed |
|
|
Term
|
Definition
|
|
Term
| Early s/s of HF in an infant |
|
Definition
-Tachycardia
-Tachypnea
-Scalp sweating
-Fatigue & irritability
-Weight gain
-Resp distress |
|
|
Term
|
Definition
| -Anti-streptolysin Q-test |
|
|
Term
|
Definition
|
|
Term
| Bladder extrophy tx pre surgery |
|
Definition
| Cover the bladder w/ nonadhering plastic wrap |
|
|
Term
| Glomerulonephritis is usually associated w/ which diagnosis |
|
Definition
| -Strep throat infection 2 weeks prior |
|
|
