335 Test 1 Review

Front 1

How to take pre op hx of client?

Back 1

remember ABCDE's

Front 2

Hx of client: name ABC's

Back 2

A: allergies
B: blood disorder (clot)
C: Cortisone (skin thin/healing probs)
D: Drugs/diabetes (control BS=risk infection)
E: Hx of emboli (DVT or hypercoag)

Front 3

What is delerium tremins and who is at risk?

Back 3

w/in 72 hrs of last drink..alcoholics at risk

Front 4

When does discharge planning start for surgery?

Back 4

pre-admission

Front 5

What are the 3 Gs?

Back 5

Garlic, ginko and ginseng

Front 6

What are other herbals to worry about?

Back 6

echinecea, ephedra, kava kava, st john's wart

Front 7

What must happen before you give pre-op meds?

Back 7

consent, bathroom

Front 8

What happens after you admin pre-op meds?

Back 8

lights low, bed low, rails up , call light handy, document

Front 9

What are the types of preop meds?

Back 9

tranquilizers, muscle relax (in order to cut thru), anticholenergics (to reduce fluid void)

Front 10

What are the stages of anesthesia?

Back 10

1. onset
2. excitment
3. surg anesthesia
4. medullary depression

Front 11

Who is at risks for Malignant Hyperthermia (MH)?

Back 11

large and lean

Front 12

How to prevent MH?

Back 12

Ask about family hx of complications with surgery

Front 13

How to tx MH?

Back 13

muscle relaxant

Front 14

What is the formula to determine MAP?

Back 14

[syst + 2(diastolic)]/3

Front 15

What is the min for MAP?

Back 15

65 mmHg

Front 16

Name the 3 stages of shock

Back 16

1. compensatory
2. progressive
3. refractory or irreversible

Front 17

Name 3 types of shock

Back 17

1. cardiogenic
2. hypovolemic
3. distributive/circulatory (neurogenic, septic, anaphylactic)

Front 18

Manifestations of which F&E disorder:
red beefy tongue, poor skin turgor, thirst, oliguria, concentrated urine, decreased BP, flattened neck vein, dizziness, weakness and confusion, INCREASE pulse

Back 18

Hypovolemia manifestations

Front 19

Manifestations of which F&E disorder:
edema, crackles in lung fields, increased BP, increased resp rate, SOB, cough, bounding pulse, JVD

Back 19

hypervolemia manifestations

Front 20

Manifestations of which F&E disorder:
constipation, irregular/weak pulse, numbness and paresthesias, U wave on heart strip, muscle weakness, orthostatic hypotension

Back 20

hypokalemia
(remember SUCTION: skeletal muscle, uwave, constipation, tox w/dig, Irreg heart beat, orthostatic hypotension, Numbness)

Front 21

What are causes of hypernatremia?

Back 21

M:medications/meals high in sodium
O: Osmotic diuretics
D: diabetes insipidus
E: Excessive water loss
L: low water intake

Front 22

Medullary deprssion is char by?

Back 22

wide pupils that don't contract in light, cyanosis, weak/thready pulse

Front 23

Headache, and N/V, more common in this type of anesthesia?

Back 23

spinal

Front 24

What is a muscle disorder chemically induced by anesthesia due to a disruption of calcium causing muscle rigidity and increased heat?

Back 24

Malignant hyperthermia

Front 25

Elderly are a risk for ______ after surgery

Back 25

hypothermia

Front 26

Ways to prevent resp complications post surg?

Back 26

incentive spir, activity, deep breath, cough

Front 27

Ways to promote cardiac output post op?

Back 27

IV fluids, monitor electrolytes, H&H, leg exercises and freq pos changes, ambulatino, pressure stockings

Front 28

Causes of which F&E disorder: increase intake, renal failure, adrenal insuff, DKA, tumor lysis syndrome, metabolic acidosis

Back 28

Causes of Hyperkalemia

Front 29

When should mammos start and how freq

Back 29

age 40 , yearly

Front 30

Which should be done first, PSA or rectal exam?

Back 30

PSA--rectal exam can cause PSA to be elevated

Front 31

When do colon screenings start and how freq?

Back 31

age 50, sigmoid q 5 yrs or colonoscopy q 10 yrs

Front 32

Pt has frq urin, urgency and sometimes difficulty passing urine--what could be the issue?

Back 32

prostate ca

Front 33

This type of tx for prostate ca involves seed implants to isolate area

Back 33

brachythreapy

Front 34

What is the sentinel LN?

Back 34

1st LN that the breast ca tissue drains into (dye injected)--cancer would spread to this area first

Front 35

procedure that takes muscle from abdomen to repair breast

Back 35

tram flap

Front 36

type of breast ca char by dimples

Back 36

Paget's dz

Front 37

Post brst ca issues

Back 37

lymphedema, fertility &preg, early menopause, body image

Front 38

Client has recurrent lung issue, coughs up blood, SOB, chest pain, decrased WT, loss of appetite, voice changes, nail changes, weakness and fever..what is the most likely diagnosis?

Back 38

lung ca

Front 39

This cancer is staged according to the muscle layer it penetrates and spread to distant LN or organs?

Back 39

colon ca

Front 40

Which two electrolytes are increased during tumor lysis syndrome

Back 40

Ca and K

Front 41

List cancer related crisis

Back 41

Sepsis, DIC, SIADH, Spinal cord compression, hypercalcemia, Superior Vena Cava compression, pain, tumor lysis syndrome

Front 42

When txing the SVC with RT to shrink tumor be sure to monitor for WHAT?

Back 42

fluid overload &&&& REnal status

Front 43

What are complications of fluid administration?

Back 43

overload, pulm edema, crackles

Front 44

Tx for hypovolemia

Back 44

ID cause, fluids, blood infusion, anidiarrheals, vassopressor

Front 45

pt presents with renal failure and heart failure, you know pt is at risk for which F&E imbalance?

Back 45

hypervolemia

Front 46

Manifestations: dyspnea, hypertension, edema, tachypnea, rapid pulse

Back 46

hypervolemia

Front 47

tx includes: sodium restriction, decrease water intake, possible IV diuretic and mech ventilation

Back 47

hypervolemia

Front 48

Person has SIADH and is experiencing lethargy, weakness, personality change and anorexia....how should you treat?

Back 48

hyponatremia tx is ID cause, 3% NaCl infusion, restrict fluids

Front 49

pt having difficulty swallowing comes in complaining of rapid pulse, nausea, twitching, hyperreflexia and you discover increased BP, how to tx?

Back 49

hypernatremia tx with gradual lowering of sodium level

Front 50

What happens if you lower the sodium level too quickly when txing hypernatremia?

Back 50

cerebral edema

Front 51

What is the normal range for potassium?

Back 51

3.5-5 mEq/L

Front 52

Pt has not had enough oranges, prunes, squash or cantelopes. He is taking an excess amount of steroids and complains of muscle fatigue and decreased resp rate, how to treat?

Back 52

hypokalemia tx is give foods with K+, slow dilute infusion of K+.

Front 53

Causes of hyperkalemia?

Back 53

burns, crushing injuries, renal failure, acidosis

Front 54

renal failure can result in which F&E disorders ?

Back 54

hypervolemia, hyperkalemia hypercalcemia hypermag, hyperphos

Front 55

What is normal range for chloride?

Back 55

95-105 mEq/L

Front 56

Worry about your HEART with this F&E Disorder

Back 56

hyperkalemia

Front 57

client has had excessive vomit, now exhibits tetany/muslce spasms, decreased resp rate. how to tx?

Back 57

give antiemetic to cure underlying cause...then tx hypochloremia by hypertonic fluids

Front 58

When kidneys detect high levels of Cl, bicarb is ______

Back 58

decreased

Front 59

high levels of Cl result in met. ______

Back 59

acidosis

Front 60

low levels of Cl result in met. _____

Back 60

alkalosis

Front 61

calcium normal range?

Back 61

8.5-10.5 mg/dL

Front 62

If kidneys don't elimate phosphorus, the calcium willl _______

Back 62

decrease

Front 63

Roles of this electrolyte includes: neuro mus fx, nerve impulse, contraction of skeletal muscle and cardiac muscle, clotting blood, maintain normal cell mem. perm.

Back 63

calcium

Front 64

Trousseau sign is used to check for which F&E disorder?

Back 64

Calcium imbalance (hypocalcemia)

Front 65

What is trousseau sign?

Back 65

BP cuff to 20 mmHg results in tetany/hook arm

Front 66

What is Chvostek sign and what is it used to test?

Back 66

facial nerve tap causes discomfort, used to test for hypocalcemia

Front 67

Client has numbness and tingling in fingers, impaired clotting, anxiety and hyperactive deep tendon reflexes...what is most likely wrong?

Back 67

hypocalc.

Front 68

what will too much calcium do to muscles?

Back 68

WEAKNESS, hypoactice deep tendon reflex

Front 69

What will too much calcium do to the heart?

Back 69

heart blocks, shorten ST and QT intervals, Bradycardia, increased BP

Front 70

If Ca is low, which other electrolyte is also probably low?

Back 70

Mg

Front 71

Normal range for Mg

Back 71

1.5-2.5 mg/dL

Front 72

magnesium levels should be measured with

Back 72

protein levels (albumin)

Front 73

alcoholism is the most common cause of this F&E disorder?

Back 73

hypomag

Front 74

Phosporus works in opposition to which other electrolyte

Back 74

calcium

Front 75

preclampsia in a female due to which F&E disorder?

Back 75

hypomag

Front 76

pt going thru chemo : how to tx anemia?

Back 76

epogen/erthropoietin

Front 77

Stomatitis

Back 77

irritation of lining

Front 78

xerostomia

Back 78

drymouth

Front 79

mucositis

Back 79

irritation of lining anywhere in GI tract

Front 80

Oral stomatitis care includes:

Back 80

rinse w/ normal saline q 2 hrs or 1/4 tsp baking soda per cup water 3-4x/day, soft toothbrush, lip lube, saliva substitute, lidocaine/antihistamine mouthwash

Front 81

things to avoid with oral stomatitis

Back 81

spicy or hot foods, commercial mouthwash, alcohol, , dentures

Front 82

What is cachexia

Back 82

increased metabolism

Front 83

Which labs to monitor in pt with urinary cystisis?

Back 83

RFTs

Front 84

combat ca fatigue with>...

Back 84

exercise, activity, keep reg sleep sched.

Front 85

chest pain is char. of this type of shock

Back 85

cardiogenic

Front 86

Pt has fluid in lungs, rapid heart rate w/ dyshythmia, fatigue, chest pain...how to tx?

Back 86

tx underlying cause of cardiogenic shock, fluids (slow), dobutamine, nitro, dopamine, oxygen, painmeds

Front 87

What might happen if fluids given to quickly for cardiogenic shock?

Back 87

pul edema

Front 88

is albumin a crystaloid or colloid solution?

Back 88

colloid

Front 89

What is balance anesthesia?

Back 89

mix inhale and IV

Front 90

what is the number 1 cause of death in a cancer pt?

Back 90

infection

Front 91

what is the best position for a person in hypovolemic shock?

Back 91

modified trendelenburg (legs elevated)

Front 92

3:1 rule involves

Back 92

amount of crystaloid fluid to be infused per loss of fluid

Front 93

blood volume pools in peripheral blood vessels defines this type of shock

Back 93

circulatory shock (distrib)

Front 94

Increase in WBC and c-reative protein signify this type of shock?

Back 94

septic

Front 95

temp decrease, bp decrease, mottled skin, increase heart rate, increase resp rate, and oliguria describes which type of shock

Back 95

septic shock

Front 96

definition of this type of shock is that there is an imbalance between sympathetic and parasympathetic nervous system stimulation

Back 96

neurogenic shock

Front 97

Pt has Dry, Warm skin, hypotensive and bradycardic...which type of shock?

Back 97

neurogenic

Front 98

lack of glucose can be a cause of this type of shock?

Back 98

neurogenic

Front 99

spinal cord injuries, spinal anesthesia and nervous system damage can be a sign of this type of shock?

Back 99

neurogenic

Front 100

lovenox would be used to tx these types of shock

Back 100

neurogenic and possible cardiogenic (thrombolytic if clot is the cause of pump fail)

Front 101

elderly are most at risk for which type of shock?

Back 101

cardiogenic

Front 102

systematic antibody-antigen rxn

Back 102

anaphylactic shock

Front 103

Mult organ dysfunction syndrome usually starts with which organ first

Back 103

lungs

Front 104

who is most at risk for MODS

Back 104

elderly

Front 105

method for screening for colon ca

Back 105

fecal occult, sigmoidoscopy, colonoscopy

Front 106

recommended cervical ca screen test, age, freq

Back 106

pap, 18, yearly (q 3 yrs if normal)

Front 107

dose of chemo based on pt ____

Back 107

BSA

Front 108

extravasation definition

Back 108

drug leaking out of vein into surrounding soft tissue

Front 109

vesicant definition

Back 109

agents that if extravasation occurs will cause necrosis of skin

Front 110

drugs to block CTZ

Back 110

zofran, kytril, anzemet,

Front 111

Who is in charge to decide if the pt is a good candidate for surgery?

Back 111

anesthetist

Front 112

T/F- 2 RN's can get consent over the phone

Back 112

True

Front 113

With verset what is important to monitor

Back 113

Airway

Front 114

anesthetics are _________ to pregnant women

Back 114

teratogens

Front 115

Crystaloid solutions

Back 115

normal saline, lactated ringers,

Front 116

Colloid solutions- what do they do

Back 116

expand, create volume, bulk up

Front 117

Paraneoplastic problems

Back 117

clotting probs, hyper-coagulation, bone mets, tumors secrete hormones, ascites, 3rd spacing, pleural effusion,

Front 118

What is the primary reason a pt die?

Back 118

infection

Front 119

If there is a problem in anesthesia or post op who do you call?

Back 119

Anesthesiologist

Front 120

What is the primary goal in nutrition?

Back 120

Keep weight up

Front 121

Hypoxia signs

Back 121

cyanosis is a late sign, restlessness/confusion