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183 Cards in this Set
- Front
- Back
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Urinaty calculi diagnosis
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Strain all urine
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Concern with a post-ileal conduit
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Edematous stoma
(Also excessive bleeding/enlargement) |
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Normal urinary output
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1500mL/24hrs
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Diet for renal faillure
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Low protein, low potassium diet
***To prevent hyperkalemia (assess cardiac function) |
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Catheter in wrong hole?
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Leave in place as a landmark
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Abdominal pressure caused by obesity contributes to
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Stress incontinence
(Teach Kegels) |
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Increased mental confusion & unexplained falls in the elderly could indicate
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A UTI
(Also loss of appetite, nocturia, dysuria) |
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To prevent a UTI
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Empty bladder Q4H even if no urge
Drink 2L of fluid a day No bubble bath, nylon underwear, scented tp Cranberry juice |
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Croupette
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Cool humidification with O2
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Hyperventilation
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Respiratory alkalosis
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Why no nose blowing post nasal surgery?
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Encourages bruising and edema
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Laryngeotracheobronchitis child in a croupette
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No teddy bears
No metal (electric spark) |
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Pursed lip breathing
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Prevents air trapping
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Trach. suction positioning
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Position head to the side opposite the bronchus being suctioned
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Pleural effusion
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Absent or decreased breath sounds
**Complication of HF, TB, Pneumonia, Cancer |
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When suctioning a trach:
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Adjust FIO2 to hyperoxygenate before AND after procedure
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Guillian-Barre Syndrome
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Trunk weakness, respiratory comprimise/failure
Vent setting - "Controlled Ventilation" for PT unable to initiate a breath |
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Metered Dose Inhaler instructions
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Shake
Hold mouthpiece 2in from mouth Count to 10 |
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COPD
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LOW CARB DIET
(High calorie, high protein) |
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Blow touch call bell with a trach?
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Yes
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Thoracentisis complication
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Subcutaneous emphysema
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For wheezing & SOB
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Aminophylline (Bronchodilator)
*Causes tachycardia, nervousness, nausea) |
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Non-productive cough
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Early symptom of O2 toxicity
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Rust colored sputum
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Pneumonia
*rust colored sputum due to inflammation |
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A tracheostomy
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Provides and maintains an airway and improves breathing capabilities (Aslo promotes secretion removal)
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Expelled outer canula of a trach.?
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Ventilate with bag if <72 hrs post-op
*a new tube this early could cause tissue damage |
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Take with INH therapy to prevent neuritis
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Vit. B6
(Pyridoxine) |
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Risk with Assist Control Ventilation
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Risk for hyperventilation
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To prevent aspiration in a CVA PT
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Position head flexed slightly forward, sitting upright when eating
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INH side effect
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Hepatitis - also: neuritis, rash, fever
(Avoid alcohol, check LFTs) |
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Addison's disease
(hypoactive adrenal gl.) |
Fluid volume defecit (fatigue, weakness, dehydration, hypotension)
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Specific gravity > 1.030
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Fluid volume defecit
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Intraoral burns/singed nasal hairs
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Potentially serious injuries
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Superficial partial thickness burns
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No blisters
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Deep partial thickness
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Blisters
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Third degree AKA
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Full thickness
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Permanent marker ok on IV bag?
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No - can contaminate solution - Use tape
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ABO Incompatibility
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Hematuria
*Also n/v, hypotension, decreased pulse & output |
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IV stops running?
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Check the site
(infiltration?) |
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Blood transfusion should run...
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Slowly -- 5mL/min. for first 15 min.
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Hypocalcemia
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Tetany (convulsions, muscular ctx., twitching, cramps)
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Potential complication of insertion of any central venous pressure line (esp. subclavian)
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Pneumothorax
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To read central venous pressure
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Place monometer level at the level of the right atrium
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Diabetes insipidus
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ADH deficiency (Water lost - Sodium left)
HYPERNATREMIA *administer pitressin |
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For hyperkalemia
(Muscle cramps, weakness, bradycardia, v. fib) |
Give Kayelexate
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Hemolytic transfusion reaction signs
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Kidney pain, hematuria, cyanosis
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Burn victim foods
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Meat and OJ
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Propranolol (Inderal) side effect
*Beta blocker for HTN |
Bronchospasm
*Asthma caution |
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Post bypass graft:
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No leg dependency/Leg crossing
**Asses with doppler Q2H |
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Lidocaine (antidysrhythmic)
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Decreases myocardial IRRITABILITY AND AUTOMATICITY
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PAD signs (Peripheral Arterial disease)
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Pain in lower extremeties not relieved by rest
Cool, mottled leg. |
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Post CABG - chest tube drainage suddenly stops
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Emergent situation - Cardiac tamponade
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Majo side effect of HCTZ (hydrochlorathiazide)
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Hypokalemia (Water and K leave the body)
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Analgesia for acute MI
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Morphine (reduces pain, anxiety & preload)
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Dopamine dosage
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According to PT weight
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If, post-MI:
Pt is SOB, fatigued, tachy... |
Check for signs of edema/weight gain (retaining fluid from HF??)
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Nitrolglycerin
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Dilates peripheral vessels, decreases preload
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90 - 95% of HTN cases
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Essential (Primary) HTN
*Cause unknown |
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Stage 1 HTN
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140-150/90-99
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CPR
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30 Compressions : Two breaths
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Clammy skin
Blood directed away from skin - towards brain & heart |
Hypovolemic shock (i.e. post-graft, hemmorage, burns, dehydration)
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Both defibrillation (emergent) and cardioversion (elective)...
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Have the same intended action (complete depolarization so SA node can takeover)and paddle placement (rt. sternal border & apex of heart)
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Avreage temps. in elderly
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Lower (96.8)
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Post MI goal
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Freedom from pain and dysrhythmias
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Intermittent claudication
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Pain in calves when walking (arterial insufficiency?)
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The most important thing about maintaing adequate circulation
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Blood volume
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First thing you say
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"Call 911"
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Orthopnea
*Inability to breathe while lying flat |
Improvement = only needing to use one pillow
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To palpate for tactile fremitus (on posterior chest wall)
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"99" -- fell with palmar and ulnar surfaces
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20/20 = NORMAL VISION
20/60 = |
A person can read at 20 feet what a person with 20/60 vision can read at 60 feet
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Second try for an absent patellar reflex
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Have pull against interlocking fingers and try again
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Rapid, involuntary back and forth eye movements
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Nystagmus
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Abdomen asessment position
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Supine, knees flexed
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Performing compare/contrast tasks
Responses to proverb questions |
Abstract reasoning assessment
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Initial health history interview
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1. Demographic data
2. Chief complaint 3. Health history 4. Lifestyle and health maintenece |
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Cheyne-Stokes breathing
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Irregular patterns of rapid waxing and waning breathing alternating with periods of apnea
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Friction rub
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Grating sounds/vibrations during inspiration and expiration
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Avg. Adult Pulse
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60-100 BPM
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PT on phone complains of a rash
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"Taking any new meds?"
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Managed care =
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Cost containment
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Request for a Nursing Reference
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Advise about the issues
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LPN - OK to do a sterile dressing change?
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Yes
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Most significant risk factor for cancer
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Advancing age
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How often to drain resivior post-mastectomy
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2x/day
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How long does it take for hair to grow back after chemo?
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1 Month
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How to dry and irradiated area
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Gently with a patting motion
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Post- Whipple procedure - NG tube drainage should be
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Serosanguinous
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PT throws tray
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Remain with them and call for help
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Early symptoms of gastric cancer
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Abdominal discomfort relieved with antacids
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Relationship between benign breast disease and developing cancer
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None
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Are the sheets radioactive?
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No
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Assess stomatitis
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Q4H blisters, sores, drainage
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Low platelets
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Soft bristled toothbrush
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Alka seltzer contains
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ASA *Bleeding risk
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Room of immunosupressed PT
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Private *wash hands pre-linen change
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Laryngeal cancer signs
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Difficulty swallowing
Hoarseness Color changes Oral lesions that do not heal |
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Anti-emetic given 30 min. prior to chemo
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Zofran
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Contraindicated with total joint replacement
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UTI
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Hgb 15 ok?
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Yes
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Normal platelet range
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150,000 - 400,000
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Take ASA with
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Food
Large glass of H20 Milk |
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Keep this in plain sight with a recent amputee
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Tourniquet
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Celebrex (Cox 2 inhibitor)
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Avoid if PT allergic to ASA, Sulfa, NSAIDS
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Probenecid (Benemid)
*for gout |
6-8 glasses of H20/day
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Rheumatoid arthritis
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Systemic
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Osteoarthritis
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Not systemic
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Important positioning for elderly post-hip replacement
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Heels off bed
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Early signs of fat embolism
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Altered mental status
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Pain in extremity while in traction (unresolved after medication)
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Compartment syndrome - perform neurovascular assessment
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Isometric exercises for muscles in cast
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Quad setting
Straight leg raises |
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NSG interventions for rheumatoid arthritis
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Heat application
Range of motion exercises |
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Padget's disease
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Get shorter (kyphosis & leg bowing)
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Hot feeling under cast?
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Check circulation in extremity
Position change |
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Car accident "I think my leg is broken?
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Cut away pants leg - then assess motor function
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Prednisone
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Increase and decrease gradually
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Residual limb home care
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Expose to air
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Important with Buck's traction
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Allow weights to hang freely at all times
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A below the knee amputation results in
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Better circulation and healing
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Rheumatoid arthritis
See contracture of wrist, what think? |
Inadequate pain management
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HCT
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Ratio of RBCs : Fluid volume
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Fluids during sickling crisis
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200cc/hr - 1600cc/8hrs.
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Precaution for sick kid visiting sickling crisis PT
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Mask
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Lymphadenopathy (enlargement of lymph nodes)
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Sign of infection
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Energy conservation technique
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Sit while prepping meals, washing
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Latex allergy propensity
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Spina Bifida
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Schilling test
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24hr Urine Test for pernicious anemia
B-12 for rest of life - cannot be absorbed orally |
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Major cause of iron deficiency anemia
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Bleeding - check stool for occult blood
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Sickling crisis can be caused by
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Infection, dehydration
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DIC main concerns
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Hemmorage, clotting
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Most common anemia
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Iron deficiency
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Diet for AIDS related diarrhea
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Limit roughage
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Risk with autoimmune thrombocytopenic purpura
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Injury
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Large doses ot cimetadine (Tagamet) can cause
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Confusion in the elderly - requires IMMEDIATE follow-up
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For DKA, give:
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Regular insulin (Humalin R)
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Administer Mevacor (lovastatin) with
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Food
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Phenazopyridin (Pyridium)
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Urinary analgesic, spasmolytic
(not antiinfective) |
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Zolmitriptan (Zomig)
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For migranes
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Chromolyn (Opticrom)
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No contact lenses
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Dilaudid (longest duration administration is)
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Rectal
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Folic acid for
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Pregnancy, liver disease, alcoholism
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Rx for glaucoma
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Pupil dilation contraindicated (so no ECT)
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Peak effect of beclomethasone (Beconase)
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Could be after as long as 3 weeks of regular use
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Give Cipro
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At equal 12 hr. intervals around the clock to maintain blood levels
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Normal respirations
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12-20/min - If lower, codine not the drug of choice for pain
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With Diarrhea - Notify physician if:
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Temp over 101.2
Blood in stool |
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Post cateract removal
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Antiemetic (i.e. Compazine) to prevent pressure at the suture line
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Note new behaviors (shuffling gait, trembles) in PT in independant living facility
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Contact physician
Pseudoparkinsonism (give Cogentin, Artane) |
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Long term bronchodilator
Takes several weeks Sides: Fatigue, nasal congestion, rash |
Montelukast (Singulair)
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Digoxin theraputic range
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0.125 - 0.5 mg
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For PT taking simvastatin (Zocor)
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Eye exam
LFT's Check HDL/LDL |
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Prescribed for Tourette's
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Haloperidol (Haldol) (antipsychotic)
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Nardil (MAOI)
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No Tyramine (Aged cheese, lunch meat, tofu, chocolate)
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Digoxin
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Contraindicated with pulse < 60
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Predinisone (Deltasone) side effect
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Altered mental status
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Celebrex and ASA
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Cross-hypersensivitity
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Prescribed for Tourette's
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Haloperidol (Haldol) (antipsychotic)
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Nardil (MAOI)
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No Tyramine (Aged cheese, lunch meat, tofu, chocolate)
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Digoxin
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Contraindicated with pulse < 60
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Predinisone (Deltasone) side effect
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Altered mental status
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Celebrex and ASA
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Cross-hypersensivitity
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Methocarbanol (Robaxin)
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Nasal congestion could mean hypersensivity
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Early sign of phenobarbitol (Luminal) toxicity
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Nystagmus - get blood specimen
Theraputic level 10--14 mcg.mL |
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Lansoprazole (Prevecid)
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Take on empty stomach
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Salt substitutes contain
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Potassium (no-go with spirolactone)
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Coumadin theraputic level:
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PT level at 1.5x control
*NO leafy greens |
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Rx for pulmonary emboli
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Streptokinase
Urokinase Alteplace (tPA) |
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If the metered-dose inhaler sinks in a bowl of water
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It's full
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B-12 containing foods
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Meat, seafood, fermented cheese
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Lisinopril (Zestril)
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For A-Fib
**No salt OR salt substitutes |
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Short term Rx for obesity
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Phentermine (Adipex - P)
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Finasteride (Proscar) side effect:
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Decreased libido/impotence
(Decreases prostate size and urinary symptoms) |
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Gabapentin (Neurontin)
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If unable to swallow pills - open capsule and sprinkle
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1 sexual partner on Flagyl...
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The other gets it too
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Dorzolamide (Trusopt)
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Sulfa drug (allergy includes topical aplications)
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All schedule drugs have
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Abuse potential
1 - highest V - lowest |
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Peak action of humalog (Lispro)
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60 Minutes
*Base dose on anticipated carb intake |
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Side effect of cholestipol (Colestid)
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Decreased absorption of fat-soluable vitamins (K,D,A)
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Type 2 DM with hyperglycemia
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Glipizide (Glucotrol)
*sulfa drug |
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Sodium/Fluid intake with Lithium
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6-10 gm sodium/day (Adequate amt.)
2000-3000mL fluid/day |
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Treat Parkinson's with
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Trihexiphenidyl (Artane)
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For diabetic neuropathy & trigeminal neuralgia
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Carbamazepine (Tegretol)
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Methotrexate is given for
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Cancer, arthritis, psoriasis
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Phenergan
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Antiemetic
**Sedative - potentiates pain med |
