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44 Cards in this Set
- Front
- Back
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signs of bowel perforation and peritonitis
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pallor, abd. distention/pain, tachycardia, tachypnea
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paracentesis(removal fluid peritoneal cavity- preprocedure
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void b4 procedure, empty bladder
measure abd. girth pos upright edge of bed, feet on stool |
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liver biopsy
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pos. supine, left lateral
pillow under right side avoid coughing and straining |
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abdominal assessment
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inspect
ausculate(for bowel sounds) percuss(for air, solids) palpate(for tenderness) |
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bowel sounds
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auscultate(5min each quadrant)
percussion palation |
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Norm bowel sounds
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occur 5-30x/min
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data collection- acute chronic gastritis
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acute(abd. discomfort, anorexia, N&V, headache hiccuping)
chronic(aneroxia, N&V, belching, heartburn after eating, sour taste in mouth, vit B def.) |
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gastric and duodenal ulcers
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gastric(GNAWING, sharp pain in left, mid epigastric region 30-60 min after eating) hematemesis more common then melena
duodenal ulcers(burning pain in midepigastric, 1.5-3hours after meal. during night, awaken pt. melena more common than hematemesis |
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dumping syndrome prevention
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avoid sugar, salt, milk
high protein, high fat, low carb small meals lie down after meals take antispasmodic med preventdumping |
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vit b12 deficiency-s/s
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smooth beefy red tongue
paresthesias of hands/feet disturbances w gait and balance (if result of intrinsic factor or disease of ileum shots od b12 weekly,monthly, lifelong) |
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food rich in b12
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brewers yeast, citrus fruits, dried beans, green leafy veg, liver, nuts, organ meats
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what is chron's disease and s/s
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inflammatory disease anywhere in GI tract leads to thickening, scarring, narrowed lumen, fistulas, ulcerations, abscesses.
s/s cramp like, colicky pain after meals diarrhea(semi solid)w mucus & pus. dehydration, electrolyte imbalances |
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divereticulosis and diverticulitis
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lower left abd. pain w coughing, straining, lifting
avoid high fiber food w inflammation occurs, irritate mucousa |
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hemorrhoids
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bright red bleeding w defecation
post op prone side lying post. prevent blding ice packs over dressing limit sitting to short periods sitz bath 3-4x/day |
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where is Mcburney's point
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RIGHT SUPERIOR ilac
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appendectomy
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pre op-
pos. R side lying, semi fowlers avoid heat to abd. expect profuse drainage from penrose to be profuse first 20 hours |
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cholecystitis
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epigastric pain radiates to scapula 2-4 after eating fatty food may persist 4-6
pain localized in R upper quadrant guarding rigidity, rebound tenderness mass palpated in R abd. MURPHYS sign(cant take deep breath when examiners fingers are passes below hepatic region bc of pain |
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acute pancreatitis
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abd. pain, sudden onset L upper quadrant radiates to back
aggravated by fatty meal, alcohol CULLENS sign(discoloration of abd. periumbilical area) TURNER's sign(bluish discoloration of flanks) Adm. Demerol for pain(avoid morphine and codeine cause spasm of Oddi sphincter) |
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Hepatitis
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Hep A-(fecal route, p2p contact, parenteral, cont. fruits/vegs/shellfish, contam. water or milk, poorly washed utensils)
HepB(blood bodily fluids, infected bld products, inf, saliva/semen, contam. needles, sexual contact, parenteral, perinatal period, bld bodily contact at birth) HEP C-(same as HepB through bld) HEP D(common among mediterranean/middle eastern,trans. same as Hep B) HEP E-(waterborne, trans same as HepA) |
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antacids
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elevate gastric PH above 5
aluminum hydroxide(contain sign. amounts of sodium. s/e constipation) magn. hydroxide-saline laxative, s/e is diarrhea) sodium bicarbonate(cause systemic alkalosis) |
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common antacids meds
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aluminum hydroxide, mag. hydroxide(Maalox oral suspension)
Calcium carbonate(mylanta, tums) magnesium hyroxide(milk of magnesia) |
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gastric protectants meds
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misoprostol (cytotec)-(give w meal, causes diarrhea and abd. pain)
sucralfate(carafate)-(empty stomach, cause constipation, impede absorp. of coumadin, dilantin, theophylline, digoxin) |
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histamine 2-receptor antagonist meds
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used w caution clients w impaired renal/hepatic function
cimetidine(tagamet) famotidine(pepcid) ranitidine(Zantac) |
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GI stimulants common meds and facts
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30mon b4 meals, bedtime
Metoclopramide(reglan) dexpantherol(ilopan) |
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medications to treat hepatic encephalopathy
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lactulose(cholac, chronulac, duphalac)
Neomycin(Mycifradin)-cautin pt w kidney impairment, reduces # of colonic bacteria that convert urea, amino acids into ammonia) |
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meds to tx inflammatory bowel disease
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metronidazole(flagyl)
cortisone predinosone(deltasone) |
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thoracentesis
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instruct client NOT to cough, breathe deeply or move during procedure
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normal value- pulse oximetry
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96-100%
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incentive spirometer- client instructions
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place mouth tightly around mouthpiece of device
2. inhale slowly, raise and maintain flow rate indicator 600-900 hold breath for 5 sec and exhale through pursed lips repeat 10x every hour |
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t-piece
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keep exhalation port on t piece open and uncovered(if occluded can cause pt to suffocate)
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COPD(chronic obstructive pulmonary disease)
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airflow obstruction caused by emphysema, chronic bronchitis
s/s- barrel chest(emphysema), use of accesory muscles, |
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Severe acute respiratory syndrome(SARS)
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spread close p2p contact w infected resp secretions or objects infected w droplets)
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pleurisy
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knife like pain aggravated on deep breathing and coughing
pleural friction rub heard on auscultation apply hot/cold applications(AP) lie on affected side splint chest |
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pulmonary embolism
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thrombus forms, travels to Rside of heart, lodges in pulm. artery
s/s-(blood tinged sputum, chest pain, cough, cyanosis, distended neck veins, hypotension, shallow resp, tachypnea, tachycardia, wheezes on auscultation, dyspnea, anginal/pleuritic pain) ad. heparin, coumadin |
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histoplasmosis
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trans. inhalation of spores, contam. soil, spores found in bird droppings
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sarcoidosis
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presence of epitheloid cells in lungs, cause unknown,
highest in blacks, young adults kveim test; sarcoid node antigen is injected intradermally cause bump in month |
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TB- tuberculosis
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trans. airborne by droplet infection, person w tb receives Bacille Calmette-Guerin vaccine positive skin test
nurse wears customized fitted mask and gown if client leaves room must wear mask Mantoux test is TB test- 10mm or more low risk. 5mm HiV pts |
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bronchodilators
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used w caution pts wHTN, DM, narrow angle glaucoma, theophylline and b2 adrenergics cause cardiac dysr., s/e palpations, tachycardia, hyperglycemia, <clotting time
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bronchodilators(sympathomimetics) meds
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inhaled
Albuterol(proventil HFA), levalbuterol(xopenex) most have rol at end oral- albuterol(volmax), terbutaline(brethine) anticholinergics- tiotropium(spiriva), opratropium(atrovent HFA) |
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inhaled nonsteroidal antiallergy agents- mast cell stabilizers meds(all but 1) tx asthma
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cromolyn sodium(Intal)-caution pts w impaired renal/hepatic function
Nedocromil(tilade) omalizumab(xolair)-anti inflam meds |
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antihistamines meds
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loratadine/pseudoephdrine(Claritin D)
fexofenadine(allegra) diphenhydramine(benadryl) desloratidine(clarinex) |
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opioid antagonists meds
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nalozone hydrochloride(Narcan)
nalmefene(revex) naltrexone(revia) |
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first line meds for tuberculosis(TB)
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INH- CI in pts w hypersensitivity,acute liver disease, risk of hepatotoxicity increases, give 1hr b4 or 2 hrs after. adm. 1 hr before antacids
rifampin(rifadin)s/e- vision changes, hepatotoxicity, hepatitis, increased uric acid levels, blood dyscrasis, colitis, take w 8ounce of water, red-orange body secretions. not physician if jaundice dev |
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first line meds for tuberculosis (TB)- pt 2
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ethambutol(myambutol)s/e- pepripheral neuritis, thromocytopenia
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