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125 Cards in this Set
- Front
- Back
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what are the manifestations of hyperthyroidism called
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thyrotoxicosis
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what are the key post op complications that may occur after a total/subtotal thyroidectomy?
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Hemorrhage, Resp. distress
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what medication will a patient need for life after a total thyroidectomy
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synthroid for life
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what is the best treatment for a thyroid storm
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treat symptoms
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what must you do when a pt is experiencing a myexedema coma
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protect the airway, have suction at bedside
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what is a precipitating cause of myxedema coma?
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precipitated by illness
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what are manifestations of hypothyroid?
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fatigue, weight gain, depression, lethargy
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what is a key intervention & what med is given for hypothyroidism
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prevent hypotension and bradycardia, maintain HR >60, levothyroxine/synthroid
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what symptoms may thyroid cancer present with
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hyperthyroid symptoms
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what are some causes of hyperparathyroidism
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cancer, vitamin d deficiency
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what are the interventions of hypoparathyroidism
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correct hypocalcemia, hypomagnesemia, vitamin d deficiency
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what is graves disease
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autoimmune disorder, thyroid forms a goiter and increases hormone secretion
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symptoms of graves disease
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exophthalmos, pretibial myxedema
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what is the discharge teaching for uveitis
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seperate tube of antibiotic for each eye, apply ointment from inner canthus to outer canthus
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cardiac assessment
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assess bp, pulse
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Stroke Volume
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the amount of blood pumped from the left ventricle each beath, affected by preload, afterload and contractility
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what should you ask the pt when doing a cardiovascular assessment
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pt history, nutritional therapy, family history, genetic risk, current health problems
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what are some physical assessment steps for the cardiovascular system
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general appearance (dusky, diaphoretic), cyanosis, rubor, clubbing, orthostatic hypotension
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what lab levels should be monitored in someone taking a statin
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liver enzymes
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what level should a nurse be concerned with in a pt who has recieved multiple blood transfusions
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elevated potassium
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an older adult with burns present with WBC 10,000, afebrile, pale wound, edema. What should the RN do?
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take blood and wound cultures
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what is trigeminal neuralgia
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causes sudden intense facial spasms and pain, chronic unilateral pain, nerve pain is sharp, shooting, burning, jabbing
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what to treat trigeminial neuralgia with |
AED's (neurotinin, lyrica). chemical nerve blocks (lidocaine)
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what is external otitis
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swimmers ear. edema and redness of the ear canal, will have mild itching or pain
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what is tinnitus and what is it a feature of?
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ringing in the ears, it is a feature of Meniere's disease
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what should you teach your pt about ear care at home
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never put anything in ear canal, clean with warm water or 50/50 mix use 2-3 drops of mineral oil if cerumen is thick and sticky
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what are some key communication tips for those who are hard of hearing
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provide well lit, quiet environment, speak slowly in a deep voice, face pt when speaking
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what is the caloric test for the inner ear
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tests for damage to nerves in the ear, first cold and then warm water is placed in the ear to test the reaction |
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what is a PTCA
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percutaneous transluminal coronary angioplasty, minimally invasive procedure where a cath is placed into femoral artery and ran to the coronary artery to open a narrowing vessel
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what is a tympanoplasty |
reconstructionof the middle ear to improve conductive hearing loss. Post-op care, use steriletechnique to change dressing, keep patient flat in bed with operative side ofheat turned up for 12 hours, do not place anything in ear canal (exceptdressing) minimize pressure in ear.
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what is a cardiac cath
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procedureused to diagnose and treat cardiovascular conditions. A catheter is inserted inneck, groin, or arm and threaded through blood vessels to your heart. It isdone to check blood flow in arteries and to check the chambers and valves
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what is an aortic aneurysm
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dilation of the aorta greater than 1.5 times normal size. Mayhave abdominal, back or neck pain. Cause weakness in the wall of the aorta andincrease risk of rupture which can lead to massive internal bleeding.Maintenance of aneurysm is to maintain blood pressure.<?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" /> |
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what is heart failure
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inability of the heart to work effectively as a pump, includes any condition that impairs the ability of the ventrucles to fill or eject blood
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what is left sided heart failure
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causes back flow into lungs, caused by HTN, CAD, and valvular disease. There are 2 types systolic and diastolic. usually comes before right. echo is the best diagnostic
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clinical manifestations of right sided heart failure
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JVD, increased abdominal girth, dependant edema, hepatomegaly, hepatojuglar reflux, ascites
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what is used to test the blink reflex in a blind patient
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air bolus
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what does HTN do to the retina
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causes vascular changes, can increase intraocular pressure and tear retina
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what is sleep apnea
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breathing disruption during sleep, muscles relax and tongue and neck structures are displaced, causing increased CO2 and decreased pH
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manifestations of sleep apnea |
excessive daytime sleepiness, inability to concentrate, irritability, headaches
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what is a myocardial infarction
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heart attack, death of heart muscle due to ischemia, MONA is immediate treatment. Typically caused by blockage
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What is BOOP pneumonia
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decreased the vital capacity which is the ability to fully empty the lungs on exhalation
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what must a RN have before preparing a pt for a procedure
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signed informed consent
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what meds are used for Alzheimer's and how do they work?
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cholinesterase inhibitors (donepezil/Aricept) slows the onset of cognitive decline. Also may be given antidepressants and antipsychotics
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What is a bronchoscopy
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procedure done to view the airway. Examine the throat, larynx, trachea, and lower airways
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what is cushings disease
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over secretion of cortisol, may cause brittle bones
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What is glucagon
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a regulatory hormone that counteracts the effect of insulin and prevents hypoglycemia by promoting the release of glucose from liver stores- secreted by pancreas
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what is insulin
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prevents hyperglycemia by allowing cells to take up, use, and store carbohydrates, protein and fat
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insulin is needed to move _________ into __________ cells.
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triglycerides; fat
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glucose and insulin are the only source of energy for what system
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CNS
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does the brain store glucose
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no, the body must maintain a steady level for the brain to use
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what hormones increase blood glucose levels
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epinephrine, norepinephrine, GH, cortisol
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clinical manifestations of insulin absence
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ketones present in urine, acidosis, kussmal (deep, fast) respirations, fruity breath
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diagnostic criteria for DKA
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blood glucose >250, arterial pH <7.3 bicard <18, low PaCO2 to compensate for acidosis, moderate ketonemia or ketonuria
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what will decrease the risk of chronic diabetic complications
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hyperglycemic, HTN, hyperlipidemia
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cardiovascular complication that may arise in a patient with DKA
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tachycardia, orthostatic hypotension
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What sort of disorder is DM II?
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progressive disorder
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in type II DM what does insulin prevent
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insulin prevents catabolism not hyperglycemia
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what level should a fasting plasma glucose be
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70-126
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hbA1c
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4-6%
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Serum osmalarity does what as a result of polyuria
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increases high is dry
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oral insulin secretagogues do what
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stimulate insulin release from the pancreas
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oral insulin sensitizers do what
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sensitizes insulin and decreases liver glucose production
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what drugs will potentiate hypoglycemia when taken with a sulfonylurea
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NSAID's, coumadin, alcohol, tricyclic antidepressants, ACE inhibitors
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What drugs worses hyperglycemia when taken with a sulfonylurea
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adrenalin, estrogen, calcium channel blockers, lasix, dilantin
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how do alpha glucosidase inhibitors work
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delays absorption of carbohydrates
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what is the peak for NPH
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4-12hrs
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insulin does what to potassium
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drives into cells, watch for low potassium
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what is a basal insulin
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gives a constant amount from the pancreas in between meals
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what is a prandial insulin
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additional insulin production to prevent glucose elevation after meals
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what diet therapy should you provide for diabetic pt
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45-65% of diet should be healthy carbs, moderate alcohol intake only
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what is keratoplasty
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surgery on the cornea, especially corneal transplantation
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what is the connection between heart failure and thyroid replacement medications
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activation of the neuroendocrine system is responsible for progressive decline in heart function
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what is natrecor
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human B-type natriuretic peptide used to reduce afterload, given IV in ICU usually |
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upper respiratory tract
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nose, pharynx, larynx, sinuses
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lower respiratory tract
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trachea, bronchus, bronchi, bronchioles, lungs, alveoli
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how is oxygen carried through the body
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on hemoglobin
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surfactant
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fatty protein that reduces surface tension of alveoli
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how many lobes are in each lung
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right 3, left 2
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what is atelectasis
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collapsing of alveoli
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what does tenderness on palpation of the sinuses signify
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infection and inflammation
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what position should the pt be in when assessing the thorax
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sitting up
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upon inspection of the tongue and sublingual area what finding would signify oxygenation problmes
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central cyanosis in the sublingual area
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what is barrel chest a sign of
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COPD
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what are the ratios for AP diameter
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1:2, 5:7
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what is flail chest and what does it look like
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flail chest is cause by a rib fracture and causes the chest to suck in
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what is fremitus
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99 test, check for vibrations all the way down
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what is percussion used for
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evaluates the level of diaphragm during resp. cycle
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how to check to see if a rub is pleural or pericardial rub |
have pt hold breath, if rub is present it is pericardial
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how many listening points are there when assesing lung sounds
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8 front 10 back
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what is a pneumothorax
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collapsed lung
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follow up care for bronchoscopy
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test for a gag
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follow up care for pt who has had a lung biopsy
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vitals, breath sounds q4, assess for resp. distress, report reduced/absent breath sounds immediately, monitor for hemoptysis (bloody sputum)
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hypoxemia
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low levels of oxygen in the blood
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hypoxia
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decreased tissue oxygenation
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a trach tube obsturction or dislodgement
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have an orbturator and replacement trach at bedside at all times
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what is a nursing priority for those with noninfectious resp. problems?
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promote oxygenation by ensuring a patent airway
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with a fracture of the nose what do you want to assess for
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patent airway, and signs of CSF leak
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what do you want to remind pt after rhinoplasty
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limit bearing down or straining
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what is asthma
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intermittent and reversible airflow obstruction affecting airways only not alveoli
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what are the main causes of asthma attacks
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inflammation and hyper responsiveness |
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what to tell pt before PFT
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no smoking for 6 hrs before test, do not use bronchodilators before or during test
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what is asthmaticus
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severe ongoing astham attacks
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what is anoxia
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no oxygen
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what is cor pulmonale
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RT side heart failure caused by pulmonary disease
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only tape used for chest tube dressing
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silk tape, drsg must be occulsive
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if a chest tube becomes dislodges what should you do
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cover insertion site with a sterile gauze and tape on 3 sides
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what is a key intervention for a pt post thoracotomy
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assess alignment of trachea
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what is pharyngitis
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sore throat
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s/s pharyngitis
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odynophagia (painful swallowing) dysphagia, fever, redness, enlarged lymph nodes
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treatment for laryngitis
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focused on relief and prevention. voice rest, stema inhalation, increase fluid intake, throat lozenges
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interventions for pt with pneumonia
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o2 above 95%, manage hypoxemia, prevent airway obstruction, drink 2L a day, prevent sepsis
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s/s TB
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night sweats, cough, mucopurulent sputum, blood streaks
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what is a pulmonary empyema
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collection of pus in the pleural space
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how is HTN defined
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systolic BP of 140 or higher and diastolic BP of higher then 90
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elevated levels of what lead to artherosclerosis
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LDL, cholesterol
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what makes up the PNS
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12 cranial nerves, 31 pairs of spinal nerves, ANS
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what makes up the autonomic nervous system
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sympathetic nervous system and parasympathetic nervous system
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what are the key assessments for neuro
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LOC/orientation
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when pt is scheduled for CT what should nurse assess for
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allergic response (shellfish, iodine) kidney function test
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in acute or status epilepticus, what meds should you give
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ativan, valium, dilantin
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what med should you not administer with dilantin
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warfarin- bleed risk
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what do you want to monitor when giving dilantin
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kidney function test |
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what is one of the key clinical manifestation of meningitis
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nuchal rigidity (stiff neck)
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when recieving drug therapy for meningitis what should be done frequently
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neuro checks
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what meds to give to treat parkinsons
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mirapex, reequip, Levadopa-Carvadopa (sinemet, symmetrel/amantadine)
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