Term
| What puts someone at risk for epistaxis? |
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Definition
| any condition that prolongs bleeding time or alters platelet count |
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Term
| Describe first aid measures to control a nosebleed |
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Definition
| apply direct pressure for 10-15 mins; partially insert gauze into nostril and apply pressure |
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Term
| Describe allergic rhinitis |
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Definition
| reaction of nasal mucosa to a specific allergen; usually occur in spring and fall; sneezing, itchy eye, watery nasal drainage, headache |
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Term
| Describe acute viral rhinitis |
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Definition
| common cold; virus can live on inanimate objects for up to 3 days; secondary bacterial infection may develop after 7 days |
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Term
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Definition
| pain over affected sinus with purulent discharge, congestion, headache fever and malaise |
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Term
| Describe acute pharyngitis |
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Definition
| can be viral bacterial or fungal; causes inflammation of tonsils, palate and uvula; fungal occurs with prolonged use of antibiotics or inhaled corticosteroids |
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Term
| What is a secondary complication of acute pharyngitis? |
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Definition
| rheumatic heart disease or glomerulonephritis |
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Term
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Definition
| chronic airflow limitation; progressive with abnormal inflammatory response in lungs; mostly caused by cigarette smoking |
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Term
| Describe the etiology of COPD |
|
Definition
| cigarette smoking causes hyperplasia of cells causing increased mucus production, reduces airway dilation making clearing mucus difficult |
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Term
| What type of genetic deficiency increases your chances of having COPD? |
|
Definition
| Alpha 1 antitrypsin (AAT) deficiency |
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Term
| Describe the patho of COPD |
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Definition
| inability to expire air, air is trapped and chest hyperexpands; patient tries to breathe when lungs are overinflated |
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Term
| What is the purpose of pursed lip breathing? |
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Definition
| prolong exhalation, prevent air trapping and prevent bronchiolar collapse |
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Term
| What is the number one symptoms of lung cancer? |
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Definition
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Term
| What types of assessment findings may you have in someone with tissue perfusion issues? |
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Definition
| cyanosis, poor capillary refill, HTN, low pulse ox, family hx |
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Term
| What are some related lab tests for tissue perfusion issues? |
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Definition
| CBC, Metabolic panel, lipid profile, drug levels, coag studies and cardiac enzymes |
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Term
|
Definition
| cardiac enzyme specific to heart muscle; remains elevated up to 2 wks after injury |
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Term
|
Definition
| cardiac enzyme; elevation detected in heart attach patients 3-4 hrs after, concentration returns to normal after 72 hrs |
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Term
|
Definition
| rise within 2-3 hrs of injury; highest 8-12 hrs and come back to normal within 1 day; can be detected sooner than troponin |
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Term
| Describe vectorcardiography |
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Definition
| records magnitude and direction of electrical forces generated by the heart |
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Term
| What should you monitor in a patient with cardiac catheterization? |
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Definition
| bleeding at the site, tissue integrity, neuro status, numbness and pulses |
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Term
| What do you monitor in a post op cardiac cath patient? |
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Definition
| VS, cardiac rhythm, pain, encourage fluids; assess site, if hematoma apply pressure and call DR; strict bedrest with leg straight |
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|
Term
| What are the SnS of coronary artery disease? |
|
Definition
| pain, dyspea, dysrhythmia, ST depression (ischemia resolving with reperfusion); symptoms typically occur with distress, normal otherwise |
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Term
| What should you look for in a patient with cardiac stent? |
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Definition
| pain, infection, stroke, SOB, vascular issues |
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|
Term
| Describe acute coronary syndrome |
|
Definition
| any condition brought on by sudden reduced blood flow to heart; unstable angina |
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|
Term
|
Definition
| necrosis of an area of heart tissue from obstruction of blood flow through coronary artery; necrosis effects heart's ability to squeeze |
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Term
| What type of lab and diagnostic info is seen in someone with MI? |
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Definition
| ST elevation, elevated cardiac enzymes, possible elevated WBC |
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|
Term
| Describe MONA treatment for someone with MI |
|
Definition
| Morphine, Oxygen, Nitroglycerin (dilates coronary arteries), Asprin |
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|
Term
|
Definition
| coronary artery bypass grafting |
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|
Term
|
Definition
| percutaneous coronary intervention; angioplasty of one or more coronary vessels w/ or w/o stent placement |
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|
Term
| Sudden cardiac death occurs from CAD why? |
|
Definition
| lethal ventricular arrhythmias |
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|
Term
| heart failure can lead to? |
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Definition
|
|
Term
|
Definition
| inability of heart to pump forward leading to fluid backup on left or right side |
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|
Term
| What are some causes of CHF? |
|
Definition
| decreased preload from hemorrhage, increased preload from excess fluids, obstructed afterload, myocardial damage |
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|
Term
| What are some symptoms of HTN? |
|
Definition
| fatigue, dizziness, dypnea, agina |
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|
Term
| What are some examples of HTN cardiac disease? |
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Definition
| CAD, L ventricular hypertrophy, HF |
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|
Term
| What are some examples of PVD? |
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Definition
| aortic aneurysm, aortic dissection |
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|
Term
| What is the DASH eating plan? |
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Definition
| dietary approaches to stop HTN |
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|
Term
| What do most HTN patients require to meet their BP goals? |
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Definition
|
|
Term
| What are some side effects of HTN meds? |
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Definition
| orthostatic hypotension, hypokalemia, sexual dysfunction, dry mouth, frequent voiding; not to be mixed with grapefruit or SJW |
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|
Term
| How does malignant HTN occur? |
|
Definition
| in those with HTN that don't comply with meds or those who were undermedicated |
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|
Term
| What does PVD affect and who is at risk? |
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Definition
| veins and arteries; smoking, diabetes, increased lipids, HTN |
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|
Term
| in vascular disease, pain is caused by what? |
|
Definition
|
|
Term
ID insufficiency:
pain with exercise, rest and diminished or absent pulses |
|
Definition
|
|
Term
ID insufficiency:
aching/cramping pain, pulses present, presence of peripheral edema |
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Definition
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|
Term
| What might you see on assessment in someone with vascular disease? |
|
Definition
| coolness, pallor, blanching, necrosis, cyanosis, atrophy (chronic ischemia) |
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Term
| What is a classic symptom of chronic peripheral arterial disease? |
|
Definition
| intermittent claudication; leg pain with movement; cramping or burning |
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|
Term
| What happens if acute arterial occlusion is not treated immediately? |
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Definition
|
|
Term
|
Definition
| venous stasis, endothelial damage, hypercoagulability |
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Term
| What is the typical amount of fluid intake for an adult per day? |
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Definition
|
|
Term
| Does muscle or fat mass carry more water in the body? |
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Definition
| muscle; tbw loss is due to increase fat over time |
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|
Term
| What are some gerontonlogic considerations for fluid balance? |
|
Definition
| changes in kidneys decrease ability to conserve water, increase ADH, reduced thirst |
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|
Term
| What is the purpose of maintenance fluids? |
|
Definition
| replaces ongoing fluid and electrolyte losses from normal physiologic processes |
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Term
| Hypovolemic patients receive what kind of fluid therapy? |
|
Definition
| replacement and maintenance |
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Term
| Describe the 4/2/1 fluid calculation method for children |
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Definition
| 4ml/kg (1st 10); 2ml/kg (11-20kg); 1ml/kg (>20kg) |
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|
Term
| What is the normal range for osmolality and the equation used to calculate it? |
|
Definition
| 280-294; 2Na+BUN/2.8+Blood glucose/18 |
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Term
| Compare colloids vs crystalloids |
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Definition
| crystalloids are majority of IV fluids and are clear; colloid are large particle fluids |
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Term
| What is the only IV fluid compatible with blood products? |
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Definition
|
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Term
| Describe the use of LR IV |
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Definition
| lactate metabolized to bicarb and given to peri op patients; surgery predisposes them to acidosis |
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Term
| Hypotonic solutions should never be given to who? why? |
|
Definition
| neuro patients; cerebral edema and increased ICP |
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|
Term
| Why may isotonic fluids be given to treat a hypotonic issue? |
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Definition
|
|
Term
| Describe the use of colloid fluids |
|
Definition
| plasma expanders, remain in vascular space and increase osmotic pressure; attracts fluid back into vasculature (vessels); treats edema |
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Term
| What is the standard treatment for someone in hypovolemic shock? |
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Definition
| 10ml/kg bolus for hypotension; 20ml/kg bolus if in shock (lactic acid increased); then vasoactive drugs PRN |
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|
Term
| What are the vasoactive drugs used in treating hypovolemic shock? |
|
Definition
| dopamine, doutamine, Norepi, Epi, neosynephrine |
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|
Term
| Salt substitutes are often high in what? |
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Definition
|
|
Term
| What is an example of a K sparing diuretic? |
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Definition
|
|
Term
| What should be done for a patient with hyperkalemia? |
|
Definition
| establish IV access and hook them up to a cardiac monitor |
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|
Term
| How does hyperkalemia present itself on a cardiac monitor? |
|
Definition
| peaked t waves and ventricular dysrhythmias (IV push) |
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|
Term
| Describe the use of binding resins in hyperkalemia treatment |
|
Definition
| promote exchange of K for Na in GI system; Need to hear bowel sounds prior to administration; lowers K over 1-2 hrs; Kayexalate |
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|
Term
| What works faster than kayexalate for hyperkalemia treatment? |
|
Definition
| insulin and glucose; facilitates uptake of glucose in cell and takes K with it |
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|
Term
| Describe the use of alkalinizing agents to treat hyperkalemia |
|
Definition
| increase pH causing temp K shift; sodoim bicarb is example, works best in underlying acidosis |
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|
Term
| What is an important clinical manifestation and treatment option for hypercalcemia and why? |
|
Definition
| Mental status change; administer fluids, excess Ca -> kidney stones |
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|
Term
| K phos or Na phos IV is ordered in what unit of measure? |
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Definition
|
|
Term
| What is an important clinical manifestation of hypomagnesemia? |
|
Definition
| increased reflexes tetany and convulsions |
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|
Term
| Describe treatment for hyperagnesemia |
|
Definition
| 1g Ca gluconate or CaCl2; opposes effects on cardiac muscle and decreases risk of dysrhythmias |
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|
Term
| What emotion can cause constipation? |
|
Definition
|
|
Term
|
Definition
| functional GI disorder with diarrhea, constipation and or abdominal pain and bloating |
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|
Term
| What are the common s/s of IBS? |
|
Definition
| pain in LLQ possible constipation with normal labs bowel sounds and appearance |
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|
Term
| Describe the Manning criteria of IBS |
|
Definition
| abdominal pain relieved by defecation, sleep associated with changes in stool frequency and distension |
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|
Term
| What is important to teach patients about regarding IBS? |
|
Definition
| chronic, ID food they can't eat, important of fiber and bulk foods, keep symptom record |
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|
Term
| When and how must a hernia truss be applied? |
|
Definition
| upon wakening with a thin layer of powder to prevent skin irritation |
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|
Term
| What are some nursing considerations for post op hernia repair care? |
|
Definition
| encourage voiding ambulation and hydration, avoid straining; splint incision with hands or pillow |
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|
Term
| What s/s in an abdominal assessment may be cause for alarm? |
|
Definition
| fever, high pulse, tachycardia, rigidity, hypotension |
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|
Term
| What are the important teaching points for somone post intestinal obstruction? |
|
Definition
| avoid fecal impaction, high fiber foods, incision care, exercise |
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|
Term
| Someone who has undergone hemorrhoidd surgery should be monitored for what? |
|
Definition
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