NUR 2 Final

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Author:
fisheatflies
ID:
83151
Filename:
NUR 2 Final
Updated:
2011-05-02 00:49:37
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Muscloskeletal etc
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Final!
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  1. 5 P’s of Neurovascular checks
    • Pain: (location, severity)
    • Pallor: (paleness, coolness, discolor)
    • Paralysis: (deficit in movement, strength)
    • Paresthesia: (changes in sensation)
    • Pulse: (distal to injury decreased/absent)
  2. Cast care- pt. teaching
    • Instruct importance of reporting any signs of impaired
    • circulation
    • Teach the 5 P’s
    • Teach pt. to wiggle extremities, elevate if s/s of impaired circulation continues call Dr.
  3. Volkmann’s Contracture
    • Due to obstructed arterial blood flow to the end of the forearm and hand
    • s/s: pain, inability to straighten fingers, cyanosis,
    • swelling
  4. S/S of peroneal nerve palsy/injury
    • Numbness
    • Burning in foot
    • Foot drop
  5. Symptom of a fat embolism
    • *Cough produces large amounts of thick white sputum
    • Chest pain
    • Increased heart & respiratory rate
  6. Symptom of compartment syndrome
    *Unrelieved pain following analgesics
  7. How to prevent dislocation after total hip replacement…
    Prevent internal rotation of the affected leg
  8. Tendinitis management
    • Cold & Heat
    • NSAIDS
  9. RICE tx of sprain/strains
    • Rest
    • Ice
    • Compression
    • Elevation
  10. SE of estrogen for management of osteoporosis (Rx Evista)
    • Spotting
    • Weight gain
    • Increased risk for DVT
  11. Effect of discontinuing corticosteroids of bone loss
    Halts progression of disease but will not restore lost bone
  12. Osteoarthritis (OA)
    • Idiopathic secondary to trauma to joint
    • *Non-inflammatory joint disease
    • Generally a part of aging
  13. Manifestations of osteoarthritis
    • Pain
    • Crepitus (sounds)
    • Herberdens Nodes
    • Stiffness (most common)
  14. What will X-rays show with osteoarthritis?
    • Joint deformities
    • Bone spurs
    • Narrowing of joint spaces
  15. High risk pt.s for Osteomyelitis
    • Poorly nourished
    • Elderly
    • Obese
    • Impaired immune systems
    • Chronic illnesses
    • Long-term corticosteroid tx
  16. Manifestation of osteomyelitis
    Sepsis
  17. Rheumatoid Arthritis
    • Systemic inflammatory disease that affects the synovial lining of joints
    • *Inflammation*
  18. Medications for Rheumatoid Arthritis
    • NSAID (ASA can cause tinnitus)
    • Prednisone
    • Corticosteroid injection into joint
  19. Manifestation of systemic lupus erythematosis (SLE)
    • Red butterfly rash across the cheeks and bridge of the nose
    • Early AM joint stiffness
    • Malaise & weakness
  20. What is affected by antigen/antibody complexes associated with SLE
    • Blood vessels
    • Mucous membranes
    • Joints
    • Skin
    • Kidneys
    • Muscles
    • Brain
    • Heart
  21. Scleroderma
    • Excess collagen causing stiff skin, small blood vesseldamage
    • Early symptom is Raynauds phenomenon
    • CREST
  22. CREST associated with scleroderma
    • Calcinosis (Ca deposits on skin)
    • Raynauds phenomenon
    • Esophageal dysfunction (acid reflux & decreased motilityof esophagus)
    • Sclerodactyly (thickening/tightening of skin on fingers&hands)
    • Telangiectasias (dilation of capillaries causing red markson skin)
  23. What causes Gout?
    Excessive accumulation of Uric acid causing crystal formations
  24. Test for Gout
    • Microscopy of synovial fluid
    • Uric acid > 7mg/dL
  25. Medications used for Gout
    • Uricosuric agents (Probenecid)
    • Antigout agents (allopurinal) *can cause decreased platelets*
  26. Decreased WBC indicative of
    • Inflammation
    • Chronic infection
  27. Complications from casts
    • Impaired circulation (5 Ps)
    • Pressure sore
  28. What exercises can be used to prevent atrophy while on bedrest?
    Isometric and ROM exercises
  29. What is elevated creatine Kinase (CK) indicative of?
    • Muscle damage
    • Non-specific to which muscle
  30. Polymyalgia Rheumatica
    • Pain in multiple muscles
    • Corticosteroids have dramatic decrease in pain & inflammation
  31. Polymyositis
    Multiple muscle inflammation
  32. Ankylosing Spondylitis
    Bent spine
  33. Sick-day rules related to diabetes mellitus:
    • Monitor blood glucose q3-4hrs
    • Continue medications as usua
    • lDiet of easily digested foods and liquids
    • Call provider is blood glucose >300 or unable to retain fluids
  34. Intervention for chemical burn to eye
    Irrigate eye for at least 10 min
  35. Dumping Syndrome
    SE of gastric surgery causing rapid stomach emptying into the duodenum when high carbs and liquids are consumed.
  36. Nutritional therapy for diverticulitis
    • High fiber
    • Low fat
  37. Pt. teaching about ulcerative colitis
    • Reduce anxiety
    • Teach pt. to about appropriate diet (bland, high protein, vit. & calories, low residue)
  38. Diet for inflammatory bowel disorders
    • Bland
    • High protein, vit. & calories
    • Low residue
  39. Clinical manifestation of thyroid storm
    • Cardiac dysfunction
    • Fever
    • Neuro impairment
  40. Foods that contain iodine
    • Seafood
    • Iodine salt
    • Dairy products
  41. Pt. teaching about barium swallow
    Explain procedure and why it’s performed
  42. What s/s post cataract surgery need to be reported/why?
    • Increase in “floaters”, flashing lights, pain
    • s/s of retinal detachment
  43. Risk r/t Menieres disease
    Risk of falls r/t vertigo
  44. Asthma-
    Chronic inflammatory disease of the airways
  45. Cheyne stokes-
    Abnormal pattern of breathing characterized by progressively deeper & faster breathing followed by gradual decrease resulting in temporary stop of breathing
  46. Types of breath sounds
    • Rales- small clicking, bubbling, or rattling
    • Rhonchi- resembles snoring
    • Stridor- wheeze-like sound
    • Wheezing- high-pitched sounds produced by narrow airways
  47. What causes angina?
    Atherosclerosis and increased demand for O2 causing pain from insufficient coronary blood flow
  48. R-sided heart failure s/s
    • Fluid retention
    • Jugular distention
    • Cyanosis
    • Enlarger liver
  49. How does Basel
    cell cancer develop?
    Usually extensive exposure to sun
  50. What labs must be monitored for pt. on Aldactone?
    • Diuretic
    • Monitor potassium lvls
    • Monitor for dehydration (BUN, creatinine, electrolytes)

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