N170 Final

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  1. Hgb
    • male 13.5-18dg/dL
    • female 12-16dg/dL
  2. HCT
    • M-40-54%
    • F-36-36%
  3. WBC
  4. Platelets
  5. Sodium
  6. Potassium
  7. Calcium
    • 4.5-5.5mEq/L
    • or 8-10mg
  8. Magnesium
  9. crepitus
    cracking sound from joints rubbing together
  10. Complication of joint replacement
    • PE or fat embolus
    • usually at day 5 post op
    • OOB asap....sequentials/Teds, heparin, ROM
    • Discharge teaching of S/S of this
  11. After surgery what are the fevers from??
    • Day 1-2 respiratory infection
    • Day 2-4 UTI
    • Day 5- Wound infection
  12. What's normal temp in the elderly?
  13. What are respirations like in the elderly? 85+
    fast and shallow
  14. Why are elderly at risk for dehydration?
    • decreased skin elasticity and turgor
    • decreased thirst, perspiration and body fluids
  15. Why are elderly at risk for malnutrition?
    • decrease taste sensation
    • decreased gastric acid and motility
    • impaired absorption, reduced saliva
  16. Who's the prevelance of pain twice as high in?  Elderly or young adult?
    Elderly are in pain more often than anybody....but have a higher pain threshold
  17. Why are psychoactive drugs more potent in the elderly?
    cuz the brain receptors are more sensitive....which causes psychoactive drugs to be MORE POTENT
  18. Primary, Secondary and Tertiery in community health
    • Primary-prevention(immun/stay healthy)
    • Secondary-what to do when they are already sick
    • Tertiary-take all meds and prevent reoccurrence
  19. Morbidity vs. mortality
    • morbidity-incidence of disease
    • mortality-number of deaths in a given period of time
  20. Gate control theory
    a pain stim opens a neurological gate, allowing pain stimulus to proceed thru the nervous system to the brain and creat the sensation of pain.  It also considers the emotional component of pain.
  21. What explains why pain is perceived differently from person to person?
  22. S/S of pain
    • increased BP and HR
    • diaphoresis
    • N/V
    • pallor
  23. Visceral pain
    pain that is crampy and gnawing....may be referred pain
  24. somatic pain
    sharp pain from skin, muscles, bones and joints
  25. Neuropathic pain
    • caused by injury to nerve fibers in the PNS or CNS
    • numbing, burning, shooting, stabbing
  26. Example of neurpathic pain
    phantom limb or diabetic neuropathy
  27. Complications of NSAIDS
    • Gi Bleeding
    • Cardio/MI
  28. adjuvant meds
    • aka coanalgesics....they add pain relief, but are not classified as pain meds
    • (antidepressants, muscle relaxers)
  29. Equinalgesia
    helps to decrease addition potential
  30.  What needs to be kept available for patient using a PCA?
  31. Cells and hypertonic and hypotonic dehydration
    • hypertonic=cell shrinkage
    • hypotonic=cell swelling
  32. VS for dehydration
    • Decreased BP
    • Increased HR/RR and depth and Temp
  33. Aldosterone causes
    sodium and water reabsorption
  34. ADH causes
    water to be reabsorbed
  35. anasarca
    accumulation of fluid in all body tissues
  36. IV for hyponatremia
    0.9% NS(Sodium Chloride)
  37. If a patient has hypernatremia....what med might they get?
  38. Primary prevention for TB
    • ID high risk people and get them vaccinated
    • people in close contact with infected should wear a mask
  39. Secondary prevention for TB
    teach infected persons they must take prescription till it's done
  40. Tertiary prevention for TB
    • Dont spend time in a stuffy enclosed room with anyone with active TB
    • Wear a mask if  you do
    • help infected to take all meds till gone
  41. Side effects of INH
    • hepatitis/liver issues
    • Renal problems
  42. Rifampin side effects
    • orange body fluids
    • less effect BCP
    • hepatitis
  43. Pyrazinamide side effects
    renal and liver issues...hepatitis
  44. Ethambutol side effects
    occular toxicity
  45. emmetropia
    normal vision
  46. ptosis
    droopy upper lid of eye
  47. chalzion
    cyst caused by obstruction in the ducts of the sebaceous glands
  48. blepharitis
    inflammtion of eye lid
  49. keratitis....and treatment for
    • inflammation of cornea
    • wear an eye patch and use atropine drops
  50. S/S of cataracts
    • blurred vision/hazy
    • NO PAIN
  51. Surgery for cataracts
    • extracapsular extraction....only done when effects ADL's
    • Contents of lens removed, but posterior capsule is left in tact for attachment of intraocular lens
  52. Patient teaching after extracapsular extraction...cataract surgery
    Dont do anything to increase IOP...no straining, leaning over, valsalva or coughing
  53. Glaucoma
    • increased IOP
    • it impairs vision and causes damage to the optic nerve.
    • Can cause blindness
  54. Open angle glaucoma
    when aqueous humor is prevented from draining due to changes in the trabecular meshowrk, canal of schlemm and adjacent canals....causing IOP
  55. S/S or open angle glaucoma
    • foggy and blurred vision
    • tired eyes
    • Gradual decrease in PERIPHERAL vision
    • HALOS
  56. Treatment of Open angle glaucoma
    cholinertic miotic-pilocarpine/physostigmine
  57. What's a medication contraindicated with glaucoma?
    ATROPINE-causes pupils to dialate
  58. surgery for glaucoma
    • trabeculectomy
    • laser surgery that creates a fistula so aqueous humor can be absorbed
  59. Close ended glaucoma
    sudden build up of IOP (1/2 to 1 hr) due to a complete blockage of the filtering angle caused by a bunching up of the iris
  60. What can cause CLosed angle glaucoma?
    Mydriatic agents
  61. S/S of closed angle glaucoma
    • Excruciating pain
    • blurred vision with halos around light

    Red eye and moderately dilated and non reactive pupil
  62. treatment for closed angle glaucoma
    medical emergency...if not treated will be blind

    Peripheral iredectomy-remove portion of iris leaving ahole for aqueous humor to get out
  63. S/S of retinal detachment
    • flashing lights or floating spots
    • curtain drawn over the eye

  64. Treatment for retinal detachment
    eye patch in hopes for the retina to go back in place prior to surgery

    • Scleral Buckling
    • sclera is shortened allowing for contact with choroid and retina
  65. What do you monitor during a nose bleed?
  66. Odd interventions for epitaxis
    • monitor CBC, PT/APTT
    • Analgesia
    • IV FLUIDS for increased blood loss
  67. Overweight
    BMI of 25 and it doesnt necessarily mean excessive body fat (muscle, bone...)
  68. Obesity
    BMI of 30....related to excessive amount of body FAT
  69. What should calories come from in our diet?
    complex carbs and proteins
  70. Serving of vegetables/fruit
    • size of a womans fist or a baseball
    • 1/2 cup
  71. Serving of meat
    • size of your palm or a deck of cards
    • 3-5 oz
  72. A serving of cheese?
    size of a thumb or 6 die
  73. What should be on my plate?
    • 2/3 plant source foods
    • 1/3 animal protein
  74. Xenical
    • blocks fat absorption and digestion
    • side effects-abdominal cramps
    • loose stool
    • vitamin deficiency
    • anal leakage
  75. Meridia
    • appetite suppressant and increases metabolic rate
    • side effects: increase BP, HR
    • constipation and insomnia
  76. Where is food dumped when you've had gastric bypass?
    directly in to the jejunum
  77. HOB for NG tube...

    after insertion
    • High fowlers
    • low to mid fowlers
  78. 2 ways to check placement of NG tube
    • X ray and aspirate fluid (should be >4...acidic. make sure you calculate amount of aspirate)
    • or
    • add 20-30 mL of air and auscultate
  79. Prior to feeding a pt with NG tube what do I do?
    check for residual (>200)
  80. When feeding a person with NG tube what do I do prior and after feeding?
    • flush with 20-30mL of WATER
  81. Where do you feel pain if you have gallbladder issues?
  82. Hepatitis A
    acute onset and has a higher fever than the other 100-104
  83. What causes jaundice?
    obstruction of bile channels causing an increase in concentration of billirubin in the blood
  84. S/S of Icteric phase of Hepatitis
    • jaundice
    • elevated billirubin
    • Dark amber/foamy urine
    • clay colored stools
    • pruritis
  85. Which hepatitis can become chronic?
    Caused by?
    • B,C,D
    • alcohol intake and increased physical exertion
  86. What can chronic active hepatitis cause?
    liver damage...hepatic necrosis and cirrhosis
  87. Which hepatitis cause liver cancer?
    B and C
  88. Epivir
    treats hep B
  89. Ribavirin
    treats Hep C

    do a pregnancy test prior to giving
  90. Precautions for Hepatitis A and E
    Standard and contact....gown and gloves, private toilet, bag and label contaminated linens, isolate tools
  91. Precautions for Hepatitis, B, C, D and G
    • Standard...wash hands
    • watch for cuts on self and mucous membranes
  92. Pt teaching for pt with Hep BCDG
    • avoid sex till LFT are normal, then use condom
    • teach friends/family how to be safe and not isolate pt
    • no sharing of razors, tooth brushes
    • repeat blood tests often
  93. Prophylaxis for Hepatitis A
  94. Prophylaxis for Hepatitis B
    Recombicax....e injections in deltoid
  95. Kubler-Ross stages of grief
    • Denial
    • Anger
    • Bargaining
    • Depression
    • Acceptance
  96. Whats an example of bargaining?
    go to get accupuncture
  97. Delayed grief response
    stuck in denial; go on after a major loss as if nothing has happened
  98. impeded grief reaction
    suddenly stop grieving....instead shop a lot, work alot, drugs, alcohol
  99. Chronic /Patholigic grief
    normal patterns that persist for very long periods of time
  100. Exaggerated grief
    self destructive behaviors....suicide
  101. Death...what goes firs? Last
    respirations first and hearings last
  102. Breathing pattern for dying
    cheyne stokes and agonal
  103. Left CVA effects
    • Right side....
    • analytical thinking
    • math skills
    • personality
    • receptive and expressive language
  104. Which side of the brain causes problems with agnosia, alexia, agraphia?
    Left side CVA
  105. Rt CVA effects
    • left side....
    • visual/spatial awareness and proprioception
    • altered perception of deficits (overestimation of abilities)
    • Poor judgement and impulse control
  106. Which side of the brain CVA causes problem with neglect syndrome?
    Rt side CVA
  107. Glascow coma scale looks at...
    • if patient opens eyes
    • has normal verbal responses...can converse
    • obeys commands with motor responses
  108. Meds for embolic CVA
    • anticoagulant...prevents development of additional emboli
    • aspirin, heparin, lovenox, warfarin
  109. Meds for thrombolytic CVA pt
    • antiplatelets....prevents extension of the CVA
    • Ticlid/Plavis
  110. Clot buster medication
    Activase, tPA
  111. What drug is given to a patient with a CVA and develops seizures
    • Antiepileptic....
    • dilantin, Neurontin
  112. Blood tests for Warfarin
    • Warfarin-PT
    • Heparin-PTT and APTT
  113. Normal temp is...
  114. Pulse deficit
    apical minus radial
  115. euypnea
    regular respirations
  116. cheyne stokes
    gradual increase in rate and depth followed by apnea
  117. kassmaul
    rapid, deep, gasping
  118. agonal
    gasping, irregular and infrequent breathing
  119. How far do you stick enema in?
    how high do you hold it?
    • 3-4 inches toward umbillicus
    • 18 inches above rectum
  120. TWE causes
    hypotonic condition
  121. What do you put in an enema for a child/infant?
    normal saline
  122. Catheter insertion....
    • it is advanced till you get urine....then-
    • female advance to more inches
    • male advance to the hub
  123. How often do you change a catheter?
    5-7 days
  124. What do you do if your catheter is clogged?
    pinch off and flush with 50mL of NS
  125. How often do you change an IV?
    48-72 hours
  126. How often do you change a TPN tube?
    every day
  127. IM needles
    21-23 gauge and 1-1.5 inches long
  128. SQ needles
    25-27 gauge and 1/2 to 5/8 inches long
  129. ID needles
    26-27 gauge and 3/8-5/8 inches
  130. When do you replace a ostomy bag?
    every 3-7 days or when it starts to detach from the skin
  131. When a person has a colostomy what are they at risk for?
    F&E imbalances
  132. Which skin cancer can metastasize?
    squamous cells....look for it on lip and ears
  133. How often do you apply sun screen?
    what is a large mole?
    how often do you examine the skin?
    • every 2 hours
    • larger than 5 cm
    • every month
Card Set:
N170 Final
2013-04-08 00:50:48
N170 Final

N170 Final
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