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460 Cards in this Set
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What are some side effects of epinephrine?
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increased HR
tightness of chest irregular HR pounding chest |
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What does epinephrine do?
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vasopressor
bronchodilates antiglycoma vasoconstrictor ehances SNS |
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What is atropine used for?
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bradycardia
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What does atropine do?
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enhances conduction of AV node to increase conduction
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What is the dosage for atropine?
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0.5 mg every 3-5 minutes
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What is the max dose for atropine?
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3 mg
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What is benadryl given for?
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hay fever
rhinnitis eczema allergic reactions |
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What is the dosage for benadryl?
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25-50mg tablets
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What is versed used for?
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sedation
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What does versed do?
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depresses CNS and seizure activity
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What does versed cause?
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amnesia
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What is versed used for?
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induction and maintenance of anesthesia
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What should you do to the versed dosage if pt is receiving opioids?
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cut by 50%
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If giving versed what should you not do?
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use small vein
vasicant |
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What is valium?
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benzo
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What is valium used for?
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anxiety, seizures
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How does valium work?
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depresses CNS
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If giving valium IV what should you not do?
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use small vein
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What should be done to the valium dosage if pt is getting versed?
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reduce about 1/3
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What is morphine?
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analgesic
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What is morphine used for?
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moderate to severe pain
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What is the usual dosage of morhpine?
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5-20 mg IM, subQ or IV
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What is demerol?
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analgesic
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What is demerol used for?
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pain relief
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What can demerol do if there is a build up?
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cause seizures d/t build up of metabolites
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What should be watched for with demerol?
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orthostatic hypotension
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What is amiodarone used for?
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v-fib and unstable v-tach
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How does amiodarone work?
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slows down conduction at the AV node and stretches response
blocks KCl leading to prolonged of action potential duration |
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What can amiodarone cause?
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heart block
blue/grey skin |
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What is the usual dosage of amiodarone?
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1.5-2.5 mcg/ml
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What is bumex?
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loop diuretic
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What is bumex used for?
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CHF
fluid overload HTN |
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1mg of bumex = how much lasix?
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40mg
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What is calicum gluconate?
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electrolyte
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What is calcium gluconate used for?
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hypocalcemia and severe hypermagnesemia
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What is digoxin?
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inotropic
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What is digoxin used for?
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cardiac failure accompained by a fib
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How does digoxin work?
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decreases conduction of electrical impulses through the AV node
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What should you do before giving digoxin?
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get apical pulse and hold if < 60
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What is mg sulfate?
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anticonvulsant
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What is mg sulfate used for?
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hypomg accompanied by signs of tetany, vtach, or vfib
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What is a normal platelet count?
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150-450,000
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Why may platelets be low if there is an infection?
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b/c the WBCs will be so high
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What should be measured with diuretics?
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24 hr I&O
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When does regular insulin start working?
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30 minutes
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When does humalog start working?
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5-15
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When do you get a peak?
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however long the drug infuses
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When do you get a trough?
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0-30 minutes before next dose
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What is a s/e of pushing steroids too fast?
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vaginal or anal twitching
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How long should you push steroids?
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1/2 ml/ min
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If giving 2ml of steroids how long should you push?
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8 minutes
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What is a s/e of pushing lasix too fast?
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deafness
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How long should you push a lasix?
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1ml/minute
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1ml= how man mg?
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10
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Should you clamp IVF if giving IV push?
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not unless they're incompatible
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What is a bolus?
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over and above infusion rate
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Why do you roll insulin?
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so you don't get suds
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How do you draw blood from a central line?
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turn off all pumps
discard 5 mls of blood first if TPN running discard 10 mls disconnect tubing and cap irrigate red, white and blue attach vacutainer and get specimen rotate specimen 8 times flush with saline attach tubing and start pumps |
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What is a portacath?
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stainless port under the skin
herbert or access needle |
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What is a passport?
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stainless port under the skin in the arm
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What are the rules with PICC?
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never use hep flushes
never anything under 10ml syringe never use vacutainers |
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What is the dosage of a hep flush?
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100 units/ ml
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What is the difference b/t a PICC and a power PICC?
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can take a lot of dyes and tests
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Which central lines don't get tape?
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hohm and hickman
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How do you mix insulin?
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clear to cloudy
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What does an antibiotic do?
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kills
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What does an anti-infective do?
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prevents replication
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What is KY?
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water based
will evaporate |
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What is vaeoline?
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oil based
not put on NG tube |
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How long does lactated ringers stay in the body?
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10 minutes
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How long does NS stay in the body?
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10 minutes
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How long does D5W stay in the vascular system?
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3 minutes
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What is a normal WBC?`
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5-10,000
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How much would 250 ml of platelets increase your hct?
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50k
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What is a normal hct?
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40
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What is a normal hgb?
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13
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What is a normal WBG?
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70-110
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What is a normal INR?
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0.75-1.25
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What is a normal PT?
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10 secs
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What is a normal PTT?
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20-40
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What is a normal BUN?
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6-26
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What is a normal creatinine?
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0.5-1.2
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What is a normal sodium level?
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136-145
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What is a normal chloride level?
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98-104
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What is a normal calcium?
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9.-10.5
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What is a normal potassium level?
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3.5-5.0
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What is a normal ph level?
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7.4
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What is a normal C02 level?
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35-45
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What is a normal HC03 level?
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22-26
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How long would you run K in a peripheral?
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10mEq/100ml
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How long would you run K in a central line?
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20 mEq/hr
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How much would a unit of whole blood increase hct and k?
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hct- 10
k- 1 |
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What is the hct level that isn't allowed to donate?
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<38
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What is the hct level that will require a transfusion?
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< 24
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What is the KVO rate for a central line?
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20ml/hr
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How long would you administer albumin?
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1ml/min or 60ml/hr
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When do you change IV bags?
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q24
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When do you change tubing?
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q4days
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When do you change IV sites?
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q4days
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What is the best source of vitamin C?
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red peppers
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What is the best source of iron?
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dried fruits
green leafys |
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What is needed to absorb iron?
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vitamin C
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What would you dilute phenergan in?
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1/4 ml in 9 ml NS
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How long would phenergan be given?
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1/2 ml/min
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What does basil mean?
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continuous administration of med
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What is the ratio of milk/molasses?
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1:1
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What meds increase clotting time?
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ASA
heparin laxatives coumadin |
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What meds decrase clotting time?
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antacids
oral contraceptives valium barbiturates |
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When should there be activity to prevent DVTs?
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q8h
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What would you need before giving lispro?
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food
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What is a guiac?
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test for blood in gastric/fecal
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What is the shock position?
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on your back with legs straight and elevated
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What is at risk with increased clotting times?
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bleeding
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What is at risk with decreased clotting time?
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clots
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What is vit K's antagonist?
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vit E
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How long can blood be out of the body for an autoinfusion?
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6 hours
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When would you not use an autoinfusion?
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< 150 in 4 hours
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When does NPH start working?
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1.5 hours
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When does 70/30 start working?
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1/2 hour
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When does lantus work?
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2 hours
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When does ultralente start working?
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4 hours
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How much is 1 cup of ice?
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125 ml
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How much is twi popcicle?
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75 ml
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1000 mcg= how many mg?
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1
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30 ml = how many oz?
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1
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60 mg = how man grains?
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1
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325 mg = how many gr?
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5 + 25 mg
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1 tsp = how many ml?
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5
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What platelet count is at a high risk for bleeding?
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50,000
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What platelet count is at a high risk for spontaneously bleeding?
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20,000
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What is a salem sump used for?
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decompression
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What is the clear tubing of a salem sump used for?
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fluids
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What is the blue pigtail of a salem sump used for?
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release of pressure
gas or air |
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How can you check placement of an NG tube?
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use catheter tip syringe to aspirate stomach contents
asculating stomach while forced air push into lumen put tubing in water and see if it bubbles |
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When would a UUN be taken for TPN?
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weekly
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What is CVP?
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assesses right ventricular function and general fluid status.
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what would a low CVP indicate?
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hypovolemia or decreased venous return
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What would a high CVP indicate?
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overhydration, increased venous return or right sided cardiac failure.
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What is PAP?
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Blood pressure in the pulmonary artery
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What would a high PAP indicate?
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a left-to-right cardiac shunt,
pulmonary artery hypertension, COPD or emphysema, pulmonary embolus, pulmonary edema, left ventricular failure |
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What would a high PCWP indicate?
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left ventricle failure,
mitral valve pathology, cardiac insufficiency, cardiac compression post hemorrhage |
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What is PCWP?
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used to measure left ventricular end diastolic pressure
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What is a normal PAP?
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8-12
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What is a normal CVP?
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2-6
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What is normal PCWP?
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6-12
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AC?
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before meals
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PC?
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after meals
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What is the largest waste of protein?
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nitrogen
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If TPN runs out what can you give?
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D10
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What do steroids increase?
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glucose
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KVO?
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never under 20ml for central line
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How much calcium can body use?
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500mg in 5 hours
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I carb serving = how many grams?
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15
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When are TEDs support hose?
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when walking
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When are TEDs antiemoblism agents?
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when lying in bed
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How long is 25mg of phenergan pushed?
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3-5 minutes
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When is a peak drawn?
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how ever long the infusion goes is how you wait after it infuses to draw
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When is a trough drawn?
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draw 0-30 minutes before next dose
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What is MBX?
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mouth wash used for sores in mouth
maalox, bendaryl and xylacaine |
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What is AGAP?
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8-16 is normal
deals with electrolytes |
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What is a cude cathther?
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has a curved end
may be used if pt has BPH |
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What is a normal Hg1AC?
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6-7
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What is the formula for an estimated average glucose?
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2.7 X Hg1AC
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What is guiac?
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occult
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What dosage does dopamine come in?
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mcg
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How do you get air out of tubing?
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clamp at both ends, aspirate with empty syringe until you get fluid
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How many mls are in 25000 units of heparin?
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250
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What is responsiveness like with minimal sedation?
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normal response to speech
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What is responsiveness like with moderate sedation?
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purposeful response to speech or touch
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What is responsiveness like with deep sedation?
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purposeful response to repeated or painful stimulation
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What is responsiveness like with general anesthesia?
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no response even to pain
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How is the airway with minimal sedation?
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unaffected
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How is the airway with moderate sedation?
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remians open
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How is the airway with deep sedation?
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may need help to maintain airway
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How is the airway with general anesthesia?
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often need help to maintain airway
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How is breathing with minimal sedation?
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unaffected
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How is breathing with moderate sedation?
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adequate
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How is breathing with deep sedation?
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may not be adequate
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How is breathing with general anesthesia?
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often requires ventilatory support
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How is heart function with minimal sedation?
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unaffected
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How is heart function with moderate sedation?
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usually maintained
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How is heat function with deep sedation?
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usually maintained
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How is heart function with general anesthesia?
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may be impaired
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What does allopurinol do?
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decrease uric acid
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When may allopurinol be given?
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high uric acid r/t chemo
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What color is an SSK tube?
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black and red
or yellow |
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Why would montgomery straps be used?
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to prevent irritation of the skin
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What is Victosa?
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slows GI absorption
taken once daily and not dependent on meals |
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What is a low sodium diet?
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2 grams/ day
no salt shaker |
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How much fluid does the kidneys filter daily?
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2000L
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How much waste, toxins and water does the kidneys remove daily?
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2 L
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What are KCL runs?
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10meq/100 IV
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How much KCL can the heart handle per hour?
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10 meq
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What is bactrim?
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anti-infectives
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What is a fracture pan?
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smaller bed pan that is easier to slide under the pt
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Why is hydrogen pyroxide in a brown bottle?
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photosensitive
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What are the four lowest nutrients in the world?
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vitamin A
iodine zinc iron |
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What are some sources of vitamin A?
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squash
pumpkins carrots |
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What are some sources of iodine?
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salt
fish |
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What are some sources of zinc?
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lean meats
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What are some sources of iron?
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dried fruits
green leafy vegetables |
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What does iron need for absorption?
|
vitamin C
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What should a BMI be?
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< 25
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What is merinol?
|
marijuana given to stimulate appetite
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What can too much tributamine cause?
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autism
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What could cause platelets increase?
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infections
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What is tunneled?
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formed tunnel to put catheter below the heart to prevent infection (hickman)
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What is hartman?
|
Lr
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What is a prealbumin test?
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right now
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What is an albumin test?
|
takes 3 weeks for a problem with albumin to show up
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What is SGPT?
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ALT
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What is SGOT?
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AST
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What is ATGAM?
|
horse serum
antibodies |
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What are some natural diuretics?
|
asparagus
cucumbers |
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What are motrin, advil and aleeve used for?
|
analgesics
anti-inflammatory |
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What does a BNO suppository do?
|
relieve bladder spasms
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What is bactriban given for?
|
strep
impetigo |
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What is coumadin?
|
anticoagulant
given at the same time everyday |
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What does status mean?
|
environment
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What does cidal mean?
|
kills
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What has estrogen?
|
soy
fatty foods |
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What is ablation?
|
catheter sends an electric shock to the SA node put pt back in sinus rhythm
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What are some sources of zinc?
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seafood
eggs green leafy vegs peanuts cheese whole bran lean meat |
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What is CPK for?
|
heart and skeletal muscle
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What is troponin used for?
|
heart
|
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What is a normal AGAP?
|
8-15
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What is AGAP used for?
|
electrolytes
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What is D-dimer for?
|
coagulation
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What is SGOT for?
|
liver
heart skeletal muscle |
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What is SGPT or ALT?
|
liver
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What is a normal INR?
|
0.75-1.25
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|
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What is a normal PTT?
|
20-40 sec
|
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What is a normal PT?
|
10 sec
|
|
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What is VMA used for?
|
24 hour urine to check for pheo tumor
|
|
|
What is a good BNP?
|
< 100
|
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What does a BNP of > 100 mean?
|
CHF
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What are BMP?
|
electrolytes
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What is a schillings test for?
|
intrinsic factor, prenicous anemia
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What is a Bense Jones test for?
|
24 hour urine to test for ca and protein to diagnose multiple myleoma
|
|
|
What is 17keto/kydroxy steroids?
|
activity of the adrenal cortex
|
|
|
What is a normal GFR?
|
125ml/min
|
|
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What is a normal CVP?
|
2-6
|
|
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What is LDH?
|
liver
lungs heart |
|
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What does sed rate measure?
|
inflammation
|
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What is CRP?
|
precursor for sed rate
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What is a normal myoglobin?
|
0-2
|
|
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What is myoglobin used for?
|
heart attack
|
|
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Why would allopurinol be given to a pt receiving chemo?
|
increased uric acid levels b/c cells are destroyed
|
|
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What does an SST look like?
|
red and black speckled tube
can also have a yellow top |
|
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Why are montgomery straps used?
|
to keep from irritating skin from frequent dressing changes
|
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What is Victosa?
|
slows GI absorption
taken once daily not dependent on meals |
|
|
What is a low sodium diet?
|
2gm/day
no salt shaker |
|
|
How much do the kidneys filter per day?
|
2000L
|
|
|
How much do the kidneys remove per day?
|
2L of toxins, waste and water
|
|
|
How much K is in a Kcl run?
|
10meq/100ml
|
|
|
How much Kcl runs can the heart handle per hr?
|
10meq
|
|
|
What can grapefruit do to some meds?
|
enhance their effects
|
|
|
What is bactrim?
|
anti-infective
|
|
|
What is a fracture pan?
|
smaller and easier to slide under the pt
|
|
|
Why is pyroxide in a brown bottle?
|
it's photosensitive
|
|
|
What are the four lowest nutritents in the world?
|
vitamin A
iodine zince iron |
|
|
What does iron need?
|
vitamin C
|
|
|
What should a BMI be?
|
< 25
|
|
|
What is merinol?
|
marijuana given to stimulate appetite
|
|
|
What can too much tributamine cause?
|
autism
|
|
|
What is tunneled?
|
formed tunell to put catheter below the heart in case of an infection
|
|
|
What is the only central line that is tunneled?
|
hickman
|
|
|
What is hartman?
|
LR
|
|
|
What is a prealbumin test used for?
|
albumin level right now
|
|
|
How long does it take for albumin to show up in a test?
|
3 weeks
|
|
|
What is SGPT the same as?
|
ALT
|
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What is SGOT the same as?
|
AST
|
|
|
What is ATGAM?
|
horse serum
antibodies |
|
|
What are cyclosporins?
|
lowers immune system to have transplant
|
|
|
What can cyclosporins be mixed with?
|
pineapple or orange juice
|
|
|
What is microdantin?
|
urinary anti-infective
|
|
|
What is pyridium?
|
pallative for UTI
turns urine orange |
|
|
What is urased?
|
pallative for UTI
turns urine blue green |
|
|
What is the sclera?
|
white of the eye
|
|
|
What does the sclera do?
|
lines the outside of the eyeball for protection and to give it shape
|
|
|
What does the cornea do?
|
forms a window that allows light to enter by binding the light
|
|
|
What is the iris?
|
disc of muscular tissue that surrounds the pupil and lies beneath the cornea and the lens
|
|
|
What does the iris do?
|
helps to regulate the entry of light by regulating the size of the pupil
|
|
|
What is the anterior chamber?
|
space b/t the cornea and the iris
|
|
|
What does the anterior chamber do?
|
has aqueous humor that has 02 and nutrients that the cornea and lens need
|
|
|
What does the vitreous humor look like?
|
clear yellow
|
|
|
What does vitreous humor do?
|
helps transmit the light
maintains position of the retina supports the posterior portion of the lens |
|
|
What is the lens?
|
avascular and transparent located behind the pupil
|
|
|
What does the lens do?
|
changes shapes to help us focus and refract the light onto the retina
|
|
|
What is the retina?
|
inner most lining of the eyeball
several layers |
|
|
What is inside the layers of the retina?
|
rods, cones and optic disc
|
|
|
When should you be checked for glaucoma?
|
by age 30 especially if they have HTN
|
|
|
What is exophthalamos?
|
protrusion of the eyeball
|
|
|
What is enophthalamos?
|
recession of the eyeball
|
|
|
What is ptosis?
|
drooping eyelid
|
|
|
When would ptosis be seen?
|
bell's palsy
|
|
|
What is a sty?
|
infection of one or more subaceous glands of the eyelid
|
|
|
What are some symptoms of a sty?
|
pain
sensitivity to light increased tearing in the affected eye always feels like there is something in the eye |
|
|
What is chalazion?
|
infection or cyst of the eyelid
|
|
|
What are some symptoms of a chalazion?
|
painless
underneath the eyelid |
|
|
What will happen if a chalazion is not treated?
|
surgery
|
|
|
What could cause a red sclera?
|
trauma
infection allergies |
|
|
What could cause a yellow sclera?
|
jaundice
|
|
|
What could cause bright red sclera?
|
broken blood vessels
|
|
|
What color should the conjuctiva be?
|
pink
|
|
|
What could case the conjuctiva to look cobble stone?
|
white and pink usually indicates allergies
|
|
|
What should the pupils be?
|
PERRLA
|
|
|
What does a rosenbaum chart test?
|
tests near vision
hand held chart hold 12-14 inches from eye |
|
|
How can you test cardinal fields of vision?
|
cover one eye, move eyes only and follow penlight or finger tip
|
|
|
When would testing cardinal fileds of vision be important?
|
glaucoma
|
|
|
What does the snellen chart test?
|
test for far vision
|
|
|
What is the top number of 20/20 mean?
|
distance from the chart
|
|
|
What is the bottom 20/20 mean?
|
distance in feet which a person with normal vision can read the line
|
|
|
Which is worse 20/30 or 20/10?
|
20/30
|
|
|
What does tonomtry measre?
|
intraocular pressre
|
|
|
What is tonomtry used to test for?
|
glaucoma
|
|
|
What are some age related changes to the eyes?
|
loss of muscle strength
loss of fat from orbit which makes the eyes look sunken dry eyes pupil reaction is slower risk for glaucoma retinal changes- need ore light to see greens, blues and violets are harder to see macular degeneration |
|
|
What is macular degeneration?
|
leading cause of blindness in age 75
|
|
|
What is conjunctivitis?
|
pink eye
allergens or irritants infectious |
|
|
What are some symptoms of conjunctivitis?
|
tearing
photosensitivity usually not painful but may occur as edema progresses |
|
|
How is conjunctivitis treated?
|
eye drops
culture good hand washing |
|
|
What is a cataract?
|
opacity of the lens is very cloudy
|
|
|
Are females or males affected more by cataracts?
|
females
|
|
|
What are some symptoms of a cataract?
|
slightly blurred vision
decreased color perception decreased visual acuity |
|
|
What is open angle glaucoma?
|
blockage of aqeuous humor that increase IOP which damages the optic nerve
|
|
|
What is closed angle glaucoma?
|
a displacement of the iris against the cornea and obstructing the outflow of aqueous humor
|
|
|
What are some interventions for post op surgery for cataracts?
|
abx
dark glassess cold compresses reduce intraocular pressure pain infection bleeding |
|
|
What would an opthhalmoscope exam show with glaucoma?
|
atrophy of the optic disc
|
|
|
What drugs would be used for pupil constriction with glaucoma?
|
miotics
beta blockers carbonic anhydrase inhibitors |
|
|
Why would you want pupil constriction with glaucoma?
|
so that the ciliary muscles is contracted and allows better circulation of the aqeous humor for better absorption
|
|
|
What drugs will inhibit aqeous humor?
|
beta blockers
systemic osmotic agents carbonic anhydrase inhibitors |
|
|
Why would prostaglandins be given for glaucoma?
|
relax the muscles in the interior eye structure that allows better outflow of aqeous humor to decrease IOP
|
|
|
What are some prostaglandins given for glaucoma?
|
lumagan
xalatan travatan |
|
|
When are prostaglandins taken?
|
once a day at bedtime
|
|
|
What are some s/e of prostaglandins?
|
severe eye stinging and darkening of the iris
|
|
|
What surgery is used for open angle glaucoma?
|
trabeculoplasty
|
|
|
What surgery is used for closed angle glaucoma?
|
irridectomy
|
|
|
What does a trabeculoplasty do?
|
increases aqueous humor flow by creating a holding pool for the aqueous humor
|
|
|
What does a irridectomy do?
|
takes part of the iris out
|
|
|
What teaching will need to be done for a post op trabeculoplasty?
|
different eye drops
|
|
|
How should beta blocker eye drops be administered?
|
push down on lacrimal gland when putting eye drops in to prevent it from getting into the systemic system to prevent decreased HR, resp problems
|
|
|
What are cotton wool spots?
|
caused from flame like hemorrhages
develop 24-48 hours 10 wks to disappear |
|
|
What would a diastolic pressure be with cotton wool spots?
|
110
|
|
|
What is wet retina?
|
lots of little hemorrhages
affects the capillaries of the retina d/t high glucose levels may go blind |
|
|
What are floaters?
|
when you blink you see dust like particles
difficulty reading or doing anything close |
|
|
How long do you have to be diabetic before any retinopathies occur?
|
10 years
|
|
|
How does diabetes cause retinopathy?
|
high glucose levels cause the vessles in the back of the retina to break and bleed so the retina swells and forms little deposits
new blood vessels form on the retinal surface which can break and bleed into the vetrious |
|
|
What are some things to do to prevent retinopathy?
|
eye exams
report and changes blood glucose control blood pressure control |
|
|
What are some symptoms of retinal detachment?
|
floaters
spots light flashes sensation of a veil-curtain across vision progression of vision deterioration |
|
|
What should be done before surgery for a retinal detachment?
|
restrict activity
eye patch |
|
|
How is surgery done for retinal detachment?
|
reattach the retina
|
|
|
What should be done after surgery for a retinal detachment?
|
eye patch
first week reduce reading, writing and close work treat and pain and nausea |
|
|
What are corneal abrasion caused by?
|
caused by contact lenses, dust, dirt, eyelashes and fingernails
|
|
|
What are some symptoms of a corneal abrasion?
|
pain
redness nausea tearing |
|
|
What is the treatment for a corneal abrasion?
|
irrigation
eye patch |
|
|
What is a laceration of the eye usually caused by?
|
sharp objects and projectiles
|
|
|
How is a laceration of the eye treated?
|
seek medical attention ASAP
check visual acuity |
|
|
What can cause a penetrating injury?
|
high speed drills
metal shards gunshot arrows and knives |
|
|
What are some symptoms of a penetrating injury?
|
severe pain
loss of vision |
|
|
How is a penetrating injury treated?
|
surgery
abx tetanus shot patch other eye |
|
|
How are blunt injuries caused?
|
sports
MVA falls physical assault |
|
|
What are some symptoms of blunt injuries?
|
eechymosis "black eye"
hyphema |
|
|
What is hyphema?
|
bleeding into the anterior chamber of the eye
|
|
|
What is a orbital blowout?
|
fracture of the orbital floor
eye contents herniated into maxillary sinus |
|
|
What are some symptoms of an orbital blowout?
|
eye may look sunken
pain may have limited eye movement |
|
|
What is the treatment for an orbital blowout?
|
place eye at rest
patch surgery abx |
|
|
What should be included in a trauma assessement of the eye?
|
assess vision unless it's a chemical burn then you irrigate first
assess eye movement unless there's a penetrating object |
|
|
How should you irrigate the eye?
|
tilt head to affected side to keep water out of the eye while irrigating
|
|
|
How long should you irrigate the eye?
|
til the pH is 7.2-7.4
|
|
|
What should be given before irrigation begins?
|
topical anesthetic
|
|
|
What is legal blindness?
|
20/200
|
|
|
What is total blindness?
|
no light perception
|
|
|
What can be done to help a blind patient while in the hospital?
|
orienting them verbally and physically to environment
lead patient around room and orient them to the room keep room free of clutter keep things in the exact place introduce self every time you enter the room and announce when you are leaving the room food tray- face of the clock help with ambulation always ask how you can help them best |
|
|
What are some things to do to prevent eye problems?
|
eye protection
eye exams for adults over 40 years use of sunglasses teach patients to wash hands |
|
|
What is conductive hearing loss?
|
anything that disrupts the transmission of sound from the external ear to inner ear
|
|
|
What can cause conductive hearing loss?
|
impacted wax
edema stenosis tumor or foreign body possible perforated tympanic membrane |
|
|
What is sensorineural hearing loss?
|
sound waves are transmitted to inner ear but some abnormality in inner ear decreases or distorts the ability to receive and interpret sound
|
|
|
What can cause sensorineural hearing loss?
|
trauma
otoxoic meds noise exposure meningitis aging infections meniere's d/s |
|
|
What are some otoxoic meds?
|
lasix
aspirin chemo aminoglycosides |
|
|
What is weber test?
|
put tuning fork on the top of the head, should feel vibration in both ears
|
|
|
What is rinne test?
|
put on back of the mastoid bone, when you can no longer feel vibration then put it by ear and ask when they can not hear it
air conduction should be greater than bone conduction |
|
|
What are some age related changes to the ears?
|
coarse wiry hair
earlobes elongate less ear wax loss of high frequency sounds |
|
|
What is cerumen?
|
foreign bodies in the ear
|
|
|
What are some symptoms of cerumen?
|
fullness in the ear
ear pain hearing loss |
|
|
What is the treatment for cerumen?
|
irrigate the ear canal with a mixture of water and hydrogen peroxide at body temperature
|
|
|
When should you not irrigate an ear canal?
|
if the ear drum is perforated
patient has otitis media never irrigate if there is severe pain |
|
|
What is cullen's sign?
|
a blue discoloration around umbilicus if pt has abdominal or peritoneal bleeding
|
|
|
What is D5LR used to treat?
|
hypovolemia
burns fluid loss mild metabolic acidosis |
|
|
What is NS?
|
0.9 %
|
|
|
What is one half NS?
|
0.45 %
|
|
|
What is one fourth NS?
|
0.225 %
|
|
|
What does mottled extremities indicate?
|
heart problems
|
|
|
What does mottled chest only indicate?
|
lung problems
|
|
|
When do you draw a vanc trough?
|
0-30 minutes before giving drug
|
|
|
When do you draw a vanc peak?
|
60 minutes after drug infused completely
|
|
|
When do you draw a gent peak?
|
30 minutes after drug infused
|
|
|
When do you draw a tobramycin peak?
|
30 minutes after drug infused
|
|
|
What is a s/e of a pheo tumor?
|
elevated BP
|
|
|
What is a salem sump used for?
|
decompression
removes pressure/gas/gastric acid from stomach |
|
|
What is sick sinus syndrome?
|
caused by dehydration or overhydration
|
|
|
How long can sterile vials be used?
|
30 days
|
|
|
When would you not give a supp?
|
if platelets are low
|
|
|
Why are lipids and TPN given together?
|
lipids help absorption of vitamins ADEK in TPN
|
|
|
What does a pt need weekly if on TPN?
|
UUN
|
|
|
How is a UUN done?
|
24 hour urine test
|
|
|
What does a UUN assess?
|
kidney abuse
|
|
|
What is amphotericin B used for?
|
histoplasmosis
|
|
|
What is a s/e of amphobericin B?
|
decreases K
|
|
|
What is amphobericin B mixed with?
|
dextroxe D5W only
|
|
|
How much should you flush before giving amphotericin B?
|
250 to 500ml saline
|
|
|
What is bumex?
|
substitute for diuretics
|
|
|
What can dilantin not be mixed with?
|
dextrose
|
|
|
What is the only tube feeding formula compatible with dilantin?
|
compleit
|
|
|
What is less than 3 mcg of dopamine used for?
|
increase renal perfusion
|
|
|
What is more than 3 mcg of dopamine used for?
|
increase HR
|
|
|
What is gama globulin?
|
an antibody
|
|
|
What is heplock?
|
heparin and sodium chloride 100units/ml
|
|
|
What is immuran?
|
most powerful immnosuppresant
|
|
|
What is inferon?
|
injection of iron
|
|
|
What should you use for inferon?
|
IM z-track method so that oil doesn't seep out
|
|
|
When would sandostatin be used?
|
fistulas or heavy secretions
|
|
|
What is zaroxolyn?
|
enhances other diuretics but only works if you give it with a diuretic
|
|
|
When would zaroxolyn be given?
|
CHF
|
|
|
How do you pull the ear to do an exam?
|
up and back
|
|
|
What would a CT of the ear show?
|
structures
|
|
|
What would an MRI of the ear show?
|
tissues
|
|
|
What is external otitis?
|
swimmer's ear
|
|
|
What causes external otitis?
|
irritating or infective agents come in contact
|
|
|
What are some symptoms of external otitis?
|
red
swelling pain fullness hear loss due to obstuction |
|
|
How is external otitis treated?
|
warm compresses or heating pad on low
topical abx topical corticosteroids |
|
|
What are some symptoms of cerumen?
|
fullness in the ear
may have ear pain may or may not have hearing loss itching or bleeding may occur |
|
|
What is otitis media?
|
infecting agent and a purulent inflammatory process starts
|
|
|
What is acute otitis media?
|
sudden onset and lasts 3 weeks or less
|
|
|
What is chronic otitis media?
|
repeated episodes
longer duration |
|
|
What can chronic otitis media cause?
|
injury to middle ear with drum rupture
|
|
|
What are some symptoms of middle ear conditions?
|
acute pain
temp decreased hearing dizziness-vertigo tinnitus |
|
|
What are some nonsurgical tx for middle ear conditions?
|
heating pad
cold may help as well systemic abx therapy ASA or tylenol |
|
|
What are some surgical treatments for middle ear conditions?
|
myringotomy if pain and eardrum continues to bulge
myringotomy with insertion of tubes for persistent infections |
|
|
What causes mastoditis?
|
develops as a result of persistent or untreated otitis media
|
|
|
What are some symptoms of mastoditis?
|
swelling behind the ear and pain
as progress may see cellulitis and spreads through the tissue lymph nodes behind the ear may be swollen low grade temp malaise ear drainage |
|
|
How is moastoditis treated?
|
cultures
IV abx removal of infective tisse simple mastoidectomy |
|
|
What is meniere's disease?
|
recurrent attacks of vertigo with tinnitus and unilateral hearing loss.
|
|
|
What causes meniere's disease?
|
infections
allergic reactions fluid imbalances long term stress overproduction or decreased reabbsorption of endolymphatic fluid causing distortion of the entire inner-canal system |
|
|
What are some symptoms of meniere's disease?
|
attacks of dizziness that can cary from several minutes to hours, may occur suddenly and without warning.
hearing loss and head noise usually accompany or precede the attacks violent spinning, whirling and falling, associate with nausea and vomiting are common sensation of pressure or fullness in the ears is common may have hearing impairment |
|
|
What is cochlear hydrops?
|
type of meniere's with ear pressure without the dizziness
|
|
|
What is the goal with meniere's treatment?
|
improve inner ear circulation and controlling fluid pressure changes within the inner ear
|
|
|
What does meniere's treatment depend on?
|
suspected cause
magnitude and frequency of symptoms |
|
|
What are some nonsurgical treatments for meniere's?
|
bedrest
IV fluids diuretic therapy low Na diet vasodilator therapy in conjuction with anti-dizziness medications avoid caffeine and nicotine |
|
|
What are some anti-dizziness medications for meniere's?
|
nicotinic acid
antivert |
|
|
What are some antihistamines for meniere's disease?
|
benadryl
dramamine |
|
|
What are some antiemetics for meniere's disease?
|
inapsine
vistaril |
|
|
Why would valium be used for meniere's diseae?
|
sedation
|
|
|
What is the surgery for meniere's disease?
|
endolymphatic decompression
|
|
|
What does an endolymphatic decompression do?
|
drains excess endolymph fluid
|
|
|
What should you tell a pt post-op after an endolymphatic decompression?
|
vertigo is temporary
|
|
|
What would a labyrinthectomy be done for?
|
meniere's disease
|
|
|
What is at risk with a labyrinthectomy?
|
severe hearing impairment
|
|
|
What should you tell your pt post op after a labyrinthectomy?
|
unsteadiness may occur for a few weeks
|
|
|
What should you teach a pt that has meniere's ds?
|
avoid sudden head movement
medic alert bracelet pull to side of raod if driving lie down if feel attack coming on |
