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51 Cards in this Set
- Front
- Back
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what is an EMG?
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an electromyogram records/evaluates electrical activity of muscles during contraction; used to differentiate between muscle dysfunction and nerve dysfunction
they can be done IM (more common) or superficially |
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what teaching should be priority when a patient ingests a contrast medium?
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increase fluid intake to promote elimination
initial stools may be white is barium was used, which is normal until all the medium is evacuated |
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what is an MRI and what is an important nursing consideration for them?
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magnetic resonance imaging; uses magnetism, radio waves and a computer to get cross sectional images of body structures
**machine is loud and may exacerbate clostrophobia. **a mild sedative may be given since stillness is important **make sure NO METAL is present in room, in/on patient's body. |
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what is ANA?
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antinuclear antibodies: seen in autoimmune diseases; these destroy the nucleus of cells.
present in RA, SLE, scleroderma etc. |
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what does the sed rate measure? (ESR)
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measures the rate at which RBCs settle out of unclotted blood.
will be INCREASED with acute infections, inflammatory conditions, SLE, pregnancy, cancers, burns, RA and rheumatic fever will be DECREASED with sickle cell anemia, degenerative arthritis, angina and factor V deficiency. |
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what is the importance of increased plasma uric acid?
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diagnostic for gout; its the end product in metabolism of purines, and the kidneys normally secret it.
hyperuricemia occurs with poor kidney function, and or excessive purine intake |
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what is the purpose of traction?
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to reduce fractures, lessen muscle spasms, relieve pain, correct deformities, promote rest and allow for exercise
skin and skeletal is most common- manual is only used briefly |
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what is countertraction?
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pulling force exerted opposite of traction direction to patient from sliding
example includes elevating the foot of the bed so the patient is at an angle (trandelenburg) |
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what is important to teach a patient in traction about massaging or rubbing painful areas?
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not to massage calves of reddened areas to prevent possible clot from dislodging
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how can a nurse facilitate plaster cast drying?
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turn the patient from side to side q2h for the first 24 to 72 hours
DONT use fingertips to turn, only palms- finger tips can create indentations in cast |
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what are important assessments for the nurse to make post laminectomy?
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CMS checks and bowel and bladder function
complaints of severe headache, N/V, abdominal discomfort = CSF leak or CSF infection some numbness and tingling is NORMAL and may persist for a little while |
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what is important to teach a patient with THR?
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avoid adduction, and 90 degree flexion of the effected hip
-avoid sitting cross legged -avoid twisting to reach for objects -avoid tub baths for 4-6 weeks - raise toilet seats and use sock pullers etc to avoid hyperflexion -**physical therapy starts the next day post op! |
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what is medication therapy for osteoporosis?
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-estrogen replacement therapy in post menapausal women is a PREVENTATIVE measure (pill or skin patch)
-calcitonin; hormone secreted by thyroid gland- it increases bone density -aledronate prevents bone resorbtion; for men and women with steroid induced osteoporosis -Evista; selective receptor modulator that prevents bone loss |
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how often should temp be assessed in osteomyletis?
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q2h!
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what is an adverse effect of long term aminoglycoside use?
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nephrotoxicity
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what is an adverse effect of long term cephalosporin use?
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hepatotoxicity
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how is muscular dystrophy acquired?
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sex linked genetic disorder
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what is compartment syndrome?
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impaired circulation caused by external pressure>30 mmHg (normal 10-20) that results in tissue death and nerve injury.
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what causes compartment syndrome?
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casts, splints, dressings, sickle cell crisis
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what are the manifestations of compartment syndrome?
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unrelieved, relentless pain, diminished or absent pulses distal to the injury, cyanosis of the extremity, parasthesia, loss of sensation, pallor, coolness, and weakness
CALL MD FOR BIVALVE ASAP! |
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when should you assess for a fat embolism and what are the S/S?
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with musculoskeletal trauma!
s/s: chest pain, dyspnea, tachycardia, decreased O2 sats, changes in LOC, petichiae on upper trunk and axilla |
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what is a sprain?
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a stretch or tear of a LIGAMENT
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what is a strain?
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a stretch or tear of a MUSCLE
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what kind of drugs are used to treat gout?
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anti-inflammatory agents like colchicines, NSAIDs, or corticosteroids
antihyperuricemics like alopurinol and uricosurics like probenecid (increase exxcretion through urine) |
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fat emboli are more associated with what kind of injury?
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a long bone fracture- particularly the head of the femur
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what is the purpose of a chest tube?
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to reestablish negative intrathoracic pressure following surgery, trauma, or pneumothorax and/or to provide drainage of blood, pleural effusion, or infected fluid (empyema)
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things to remember about care of a patient with a chest tube:
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-keep it below the level of the chest = gravity
-occlusive dressing around tube -NEVER milk the tube unless ordered* -NEVER clamp chest tube -monitor output hourly |
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what is seen in the water seal chamber of a chest tube device?
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few bubbles that fluctuate with breathing
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emphysema:
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barrel chest
difficulty exhaling strongly associated with smoking "pink puffer" persistant tachycardia bc of inadequate O2 hyperinflated lungs and flattened diaphragm increase fluid intake = liquify secretions immunization against pneumonia q5 years |
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chronic bronchitis:
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chronic airway inflammation
productive cough that lasts atleast 3 months smoking main cause inflammation= hyperplasia of mucus secreting glands= excessive sputum production ineffective clearance- frequent infections polycythemia develops to compensate to chronic hypoxia "blue bloater" |
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drug therapy for COPD
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bronchodilators are controversial- beta adrenergic agonist used in place (nebulizer or MDI)
anticholinergics (ipratropium/atrovent) = maintanance therapy by inhaler is MOST EFFECTIVE for COPD long acting theophyline- controversial but strengthens diaphragm = decrease work of breathing corticosteroids: controversial but good for pts with asthma or frequent exacerbations unresponsive to beta agonsits |
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viral pnuemonia
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low grade fever
non productive cough normal to small elevated WBC less severe than bacterial |
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bacterial pnuemonia
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high fever
productive cough high WBC obvious infiltrates in chest x ray more severe than viral |
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TB
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acid fast bacillus (acid fast sputum test)
infection results from frequent close contact with infected person immunity = granuloma lesion part of this lesion = Ghon focus and material from here = passage of infectious particles to more airways WHERE THEY CAN BE EXHALED characteristic frothy pink sputum early symptom: nonproductive early morning cough keep patient in private room with negative pressure HCP wears N95 mask, patient wears normal face mask INH for 12 months = drug of choice w/abnormal chest x ray or immunocompramized (HIV) |
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what part of the CNS controls cardiac function?
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ANS: regulates cardiac function and BP
balance between sympathetic and parasympathetic branches |
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what role does the SNS have in cardiac function?
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produces epinephrine and norepinephrine = increasing HR, myocardial contractility, and peripheral vasocontriction resulting in raised BP
(FLIGHT/FIGHT) |
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what role does the PSNS have in cardiac function?
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produces acetocholine = lowered HR and decreased contractility, opposite of sympathetic stimulation
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what are early signs of digoxin toxicity?
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N/V, anorexia, abdominal pain, bradycardia/dysrhythmias, and yellow/green visual halos
**hypokalemia increases the risk of Dig toxicity |
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how is sinus tachycardia treated?
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treated only when patient is symptomatic or at risk for mycardial damage
treat underlying cause (hypovolemia, fever, pain etc) beta blockers or verapamil may be used |
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how is sinus bradycardia treated
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treated only when patient is symptomatic
IV atropine or pacemaker therapy may be used **athletes may have sinus bradycardia without any decrease in CO (heart is stronger/more efficient) |
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how is PAC treated?
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reduce alcohol, caffeine intake
reduce stress stop smoking |
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what is left sided heart failure?
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decreased ability of LV to pump blood into systemic circulation = decreased CO and back of blood into pulmonary circulation
symptoms: -dyspnea on exertion (1st sign) -orthopnea -new S3 -crackles, pulm edema |
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what is right sided heart failure?
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RV has reduced capacity to pump blood into pulmonary circulation causing back up in venous circulation
symptoms: -edema of lower extremities -JVD -abdominal discomfort and nausea from liquid congestion in the abdominal organs |
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how do ACE inhibitors reduce BP?
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inhibits the conversion of angiotensin1 to angiotensin 2 (a potent vasoconstrictor)
reduces peripheral resistance without changing CO used in HTN, raynaud's syndrome, CHF |
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how do beta blockers reduce BP?
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decreasing CO response to sympathetic nerve stimulation and renin secretion by the kidneys
reduces sympathetic vascular resisitance used in -HTN -MI -Arrhythmias ***avoid in patients with COPD |
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how do ARBs reduce BP?
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blocks vasocontrictive effects of angiotensin 2
used in -HTN alone or with LV hypertrophy, neuropathy, and T2DM |
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peripheral arterial disease:
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patient experiances intermittent claudication
pain is relieved when extremity is in DEPENDANT position |
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what is Chron's disease aka regional enteritis?
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chronic inflammation of the GI anywhere from mouth to anus but mostly occurring in iterminal illium
cause is unknown but probably autoimmune lesions have "cobblestone appearance" |
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what assessment findings in chron's disease?
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5-6 liquid stools a day, usually without blood
depending on location, stegorrhea may occur abdominal pain in RLQ that is relieved by defecation barium enema DX shows ulcerations, narrowing, strictures, and fistulas |
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what is the prescribed diet for Chron's disease?
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high calorie, high protein. usually also need nutritional supplements
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what should a patient with BPH avoid?
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anticholinergics bc they cause urinary retention
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