NUR 112 Spring '12 1st 8 weeks
Card Set Information
NUR 112 Spring '12 1st 8 weeks
What causes appendicitis?
obstruction in the lumen
Why is it important to not give pain medications to someone who c/o abd pain that may be r/t appendicitis?
administering pain meds will mask sxms, increased abd pain is sxm of appendicitis
Why should we treat appendicitis quickly?
risk for peritonitis
Who gives report to PACU nurse after surgery?
Who suprvises, confirms, and records final sponge and instrument count after surgery?
Why should pts ambulate post-op?
prevent complications such as DVT
Define paralytic ileus
absence of bowel sounds
How do you correctly use a spirometer?
inhale slowly, deeply, and hold
Describe a wound healing by primary intention.
incision made by surgeon and it is well approximated
Describe a wound healing by secondary intention.
not well approximated; needs more tissue replacement, often contaminated, and takes longer time to heal
Describe a wound healing by tertiary intention.
intentionally left open to promote healing, prevent infection; a delayed primary intention
Dry mucous membranes, increased RR, flattened neck veins, increased HR and decreased BP are signs that a pt has too much of which electrolyte?
Na+; s/s of hypernatremia
Peripheral edema and neck vein distention are signs that a patient is deficient in which electrolyte?
Na+; s/s hyponatremia
Normal sodium level is _____.
Normal potassium level is _____.
What sxms do you expect to see with hypokalemia?
muscle wekness; weak/thready pulse, shallow respirations, leg cramps
What sxms do you expect to see with hyperkalemia?
irregular/slow HR; peaked T waves, muscle cramps
Too much _____ will cause muscle cramps and irregular/slow HR.
What can you give to lower potassium level in a pt with hyperkalemia?
kayexalate; calcium gluconate; IV insulin
Normal phosphate level is _____.
Normal calcium level is _____.
Normal magnesium level is _____.
Which electrolyte excess manifest flabby muscles?
Which electrolyte deficit manifests Chovstek's or Trousseau's?
Normal PCO2 is ____.
Normal PO2 is ____.
Normal HCO3 is ____.
If a pt has metabolic acidosis, how will his breathing pattern be to compensate for excess acids?
Kussmaul (deep rapid breathing)
CNS depression is a symptom exhibited in pts who have what kind of ABB imbalance?
If a pt is
, had gastric suction, has peptic ulcers, and blood pH >7.35, which ABB imbalance pt exhbiting?
vomiting=losing H+ ions!
Which oxygen delivery method deilvers 20-40% O2 concentration?
Which O2 delivery method delivers 40-60% O2 concentration?
Simple Face mask
Which O2 delivery method delivers most precise O2 concentration?
Which O2 delivery method has a one way valve?
Nonrebreather mask; prevents room air from entering mask
Which O2 delivery method requires nurse to frequently empty condensation from tubing?
Aerosal Mask/Face Tent/Tracheostomy
Where is air warmed, filtered, and humidified?
What are the functional units of the lung?
Which bronichi is aspiration more likely to occur and why?
Right d/t shorter, straighter, and wider structure.
What is the name of a lung disease that involves damage to alveoli so that they can't completely deflate and fill with fresh air?
What is a classic sxm of pt with emphysema?
What is classic sxm of pt with chronic bronchitis?
"blue bloater"; barrel chest
How can you be sure that someone has pulmonary edema?
pink, frothy sputum
What is RSV?
Respiratory syncytial virus; pt wheezes, has deeper cough, and labored breathing.
What is a COPD pt's drive to breathe?
What can happen if we give too much oxygen given to a pt with COPD?
compromise drive to breathe; COPD drive to breathe = increased CO2
Coryza, Malaise, Fever, Cough characterizes
Thyrotoxicosis is a sign of _____.
Myxedema is a sign of _____.
Grave's disease is associated with _____.
hyperthyroidism; excessive output of thyroid hormones caused by abnormal stimulation of thyroid gland by circulating immunoglobulins
Constantly flushed skin, cannot sit still, palpitations, rapid pulse at rst, prespire freely are signs of which thyroid condition?
Brittle nails, extreme fatigue, hair loss, numbness/tingling of fingers are signs of which thyroid disorder?
Fine tremor of hands, increased appetite, progressive weight loss are signs of what thyroid disorder?
How do you restore consciousness if myxedema progresses to myxedema coma?
What kind of diet is a pt with hyperthyroidism on?
high calorie-high protein
Chronic thyroiditis is also known as _____
After a thyroidectomy, what is always kept at the bedside?
tracheostomy set; edema of glottis my occur leading to resp. difficulty
What should pt with a thyroidectomy order avoid consuming?
coffee; stimulants like caffeine
Hypoparathyroidism exhibits what sxms?
tetany, Trousseau's, Chvostek's; rationale: PTH controls release of Ca+, therefore a deficiency of PTH means also deficiency of Ca+
What BMI range is considered overweight?
Where is glucose stored in pts with TYpe 1 DM?
stays in blood stream, cannot be stored in liver d/t lack of insulin
Are ketones more prevelant in Type 1 DM or Type 2 DM?
rationale: no insulin to inhibit breakdown of fat. Ketones are byproducts of fat breakdown.
Which pt are you more likely to see obesity/weight gain? Type 1 or Type 2 DM?
Type 2 DM
What 3 factors are dx DM?
FPG >=126; casual plasma glucose >200; OGTT: >=200
What percentage of carbs consumed are converted to glucose?
A patient with DM should not exercise if what two factors are present?
ketones in urine; BS >250
pts with IDDM are advised to do what before exercising?
eat 15 g carb snack
to prevent hypoglycemia
Onset, Peak, Duration of Rapid Acting Insulin
Onset = 5-15 minutes; Peak=30 min-1 hour; Duration=2-4 hours
What is the onset of rapid acting insulin?
What action does sulfonylureas & meglitinides have on DM Type II pts?
of insulin by beta cells
What action do biguanides have on DM pts?
increases body tissues' sensitivity to insulin, inhibits glucose prod by liver
Upon observation of an intermediate insulin vial, how do you know when it should not be used?
if it has a frothy, white coating then it should not be used
What drug is used to prevent DM or slow destruction of beta cells?
How do you treat a pt experiencing Somogyi phenomenon?
Decrease insulin level, give bedtime snack
How do you treat dawn phenomenon?
change evening dose of insulin; give it later so it will peak later
What happens in the final stage of diabetic retinopathy?
blood vessels velop on surface of eye in vitrious, retinal detachment may occur
What is Cullen's sign?
What is Grey Turner's sign?
bruising of the flanks
How is acute pancreatitis dx?
serum amylase >500; elevated urinary amylase; elevated serum lipase level; WBC, serum glucose, BUN, and LDH elevated; bulky pale foul smelling stool
Why are pts with acute pancreatitis at risk for skin breakdown?
What do alpha cells secrete?
What do beta cells secrete?
What are the 4 stages of carcinogenesis?
1. Initiation 2. Promotion 3. Progression 4. Metastasis
What stage of CA do carcinogens damage the cell's DNA and genes?
All CA cells are a threat. (True/False)
False. Only CA cells that can divide are a threat.
In what stage do carcinogenesis mutate a cell's genes?
In what stage of oncogenesis is the growth of the CA cell enhanced?
In what stage of carcinogenesis does a tumor produce TAF?
What is TAF?
tumor angiogenesis factor; blood vessels branch into tumor to give it nutrition
In what stage of CA development does CA cells spread to other parts of body?
What are secondary tumors?
aka metastatic tumors; break off from primary cell and end up in another area of body (i.e. lung cell found in uterus)
What is grading?
compares CA cell with parent tissue; how close does it resemble the parent cell?
What is staging?
determines exact location of CA and its degree of metastasis at dx.
What is carcinoma in situ?
early stage CA cells that has not spread to neighboring tissues
What does a TIS, N0, M0 staging of CA mean?
TIS=carcinoma in situ (has not spread to neighboring tissue); N0=did not spread to lymph nodes; M0=no metastasis
What does a T4, N3, M1 staging of CA mean?
larger size, involes lymph nodes, has spread
What is the exposure of radiation?
amount of radiation delivered to a tissue
What is the dose of radiation?
amount of radiation absorbed by tissue
What 3 factors determine absorbed dose of radiation?
intensity, duration, and closeness of exposure
What is xerostomia?
Which CA therapy is systemic?
Which CA therapy is localized?
What is thrombocytopenia?
low platelet count ----> @ risk for bleeding
What is NPPV mask?
noninvasive positive pressure ventilation