Med/surg Test 2

Front 1

Acute arterial occlusion s/s

Back 1

Poikilothermia (cool)
Pulselessness
Paresthesia
Paralysis
Pale (pale mucous membranes also)
Pain

Front 2

Who gets chronic arterial occlusive disease earlier in their life?

Back 2

People with Diabetes

Front 3

Causes of thrombophelbitis

Back 3

venous stasis
damaged endothelium
hypercoagulability

Front 4

What is used to measure effectiveness of heparin?

Back 4

APPT

Front 5

What is used to measure effectiveness of coumadin?

Back 5

INR

Front 6

What is compatible with heparin IV?

Back 6

nothing

Front 7

Coumadin is influenced by what dietary element?

Back 7

Vitamin K
Many meds interfere with vit K

Front 8

swelling (inflammation) of a vein caused by a
blood clot

Back 8

thrombophlebitis

Front 9

What are the 2 types of COPD?

Back 9

Chronic bronchitis
Emphysema
(though most people with COPD have both conditions and possibly other conditions like asthma)

Front 10

This is the presence of chronic productive cough for 3 months in each of 2 consecutive years in a patient in whom other causes of chronic cough have been excluded

Back 10

Chronic bronchitis

Front 11

This is the abnormal permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis

Back 11

Emphysema

Front 12

COPD is the ___ leading cause of death in the US?

Back 12

4th

Front 13

What is the prognosis for people with COPD?

Back 13

1/2 of patients die within 10 years of diagnosis
(though this is complicated by the fact that most people are not diagnosed until the disease is advanced)

Front 14

This causes:
SNS activation (increased HR, vasoconstriction, BP, and cardiac workload)
decreased functional hemoglobin
increased platelet aggregation

Back 14

nicotine

Front 15

What is the primary process of COPD?

Back 15

inflammation

Front 16

In COPD, what is the result of inflammation?

Back 16

production of more goblet cells (more mucus)
repeated damage and repair of lung tissue results in increased collagen and scar tissue formation (fibrosis)

Front 17

Hypertrophy of the right side of the heart resulting from pulmonary hypertension

Back 17

cor pulmonale

Front 18

What test value determines the diagnosis of COPD?

Back 18

FEV1/FEV

(FEV1/FEV <70%)

Front 19

Alveolar hypoxia and acidosis cause vasoconstriction, vascular remodeling, erythropoiesis. This increased viscosity of blood and decreased arterial diameter lead to what?

Back 19

Increased pulmonary vascular resistance

Cor pulmonale

Front 20

Cor pulmonale affects what side of the heart?

Back 20

right

Front 21

s/s:
jugular venous distension
hepatomegaly with rt upper quadrant tenderness
ascites
epigastric distress
peripheral edema
weight gain

Back 21

right-sided heart failure

Front 22

hypercarbia

Back 22

abnormally high level of carbon dioxide in the circulating blood

Front 23

sedatives, benzos, and opioids can do what to the COPD patient?

Back 23

a lack of drive to breathe leading to respiratory failure

Front 24

Why should COPD patients be monitored for occult blood in the stool and gastric aspirate?

Back 24

They have increased risk for duodenal ulcers that do not cause pain. This may be caused by increased gastric acid resulting from increased CO2 in patients who chronically retain CO2.

Front 25

What is the most effective intervention to stop the progression of COPD?

Back 25

stop smoking

Front 26

What do bronchodilators do for COPD patients?

Back 26

relaxes smooth muscle in the airway which improves the ventilation of the lungs and decreases SOB

Front 27

This drug's main benefit is to improve contractility of the diaphragm and decrease diaphragmatic fatigue

Back 27

long-acting theophylline

Front 28

These drugs for COPD help by decreasing inflammation. They are not helpful in mild cases, only with moderate-severe cases. They should not be used for long-term therapy.

Back 28

inhaled corticosteroids

Front 29

What should you have the patient do before obtaining a sputum specimen?

Back 29

rinse mouth with water
take several deep breaths, then cough

Front 30

How many liters of oxygen should someone with COPD receive?

Back 30

1-2 liters/min

Front 31

What is a pneumothorax?

Back 31

air in the plural space, causing the lungs to collapse

Front 32

Assessment:
absent or diminished lung sounds
hyperresonance
use of accessory muscles for breathing
prolonged expiration
pulsus paradous (large decrease in systolic BP during inspiration)
decreased air flow rates
decrease oxygen saturation

Back 32

asthma

Front 33

Barrel chest is found in which condition?

Back 33

Emphysema

Front 34

Assessment:
cough
exertional dyspnea
sputum production
use of accessory muscles for breathing
prolonged expiration
orthopnea
respiratory acidosis
decreased vital capacity

Back 34

COPD

Front 35

What is orthopnea?

Back 35

A condition in which there is difficulty in breathing except when sitting or standing upright.

Front 36

What intervention used for COPD or pneumonia will help with mucus buildup?

Back 36

Drink up to 3000 mL/day water
Administer mucolytics

Front 37

What breath sounds might you hear with pneumonia?

Back 37

rhonchi and wheezes

Front 38

How long does it take for TB meds to greatly reduce the likelihood of transmission?

Back 38

2-3 weeks

Front 39

How is TB transmitted?

Back 39

droplets (laughing, coughing, singing)

Front 40

Assessment:
fatigue
anorexia
low-grade fever
chills
night sweats
persistent productive cough
occasional blood streaks in mucus

Back 40

TB

Front 41

When do most client's have a negative TB sputum test?

Back 41

after 3 months of treatment

Front 42

When can someone with TB usually go back to work?

Back 42

After 3 sputum tests have come back negative

Front 43

The accumulation and sequestration of trapped ECF in an actual or potential body space as a result of disease or injury.

Back 43

Third-spacing
can cause compartment syndrome

Front 44

anasarca

Back 44

generalized edema, excessive accumulation of fluid in the interstitial spaces usually due to organ failure

Front 45

Why are infants and elderly at greater risk of fluid problems?

Back 45

Baby has higher % body water (80%)
normal adult is 60%
elderly is only 55%

Front 46

This IV fluid pulls fluid from the interstitial compartment into the vascular compartment.

Back 46

Colloids

Front 47

Used to increase vascular volume rapidly, such as in hemorrhage

Back 47

Colloids

Front 48

This IV fluid causes movement of water from cells into extracellular fluid

Back 48

Hypertonic:
Anything over 0.9% NS
Most dextrose infusions

Front 49

This IV fluid causes movement of water into cells

Back 49

Hypotonic:
Anything less than 0.9% NS

Front 50

This IV fluid increases the extracellular fluid volume

Back 50

Isotonic:
0.9% NS
D5W
D5W 1/4 NS
LR

Front 51

About how much water is lost through the skin every day?

Back 51

400mL

Front 52

What is insensible water loss?

Back 52

Loss that the person doesn't know about, like through the skin and lungs

Front 53

What is the average amount of water lost through the lungs every day?

Back 53

350 mL

Front 54

Which IV solution should be given slowly?

Back 54

Hypotonic (to prevent edema)

Front 55

Assessment:
Polyuria
Diarrhea
Nonpitting edema
Dysrhythmias
Projectile vomitting

Back 55

Hypotonic overhydration (water intoxication)

Front 56

Normal sodium level

Back 56

135-145 mEq/L

Front 57

Assessment:
Rapid pulse
Diminished deep tendon reflexes
Hyperactive bowel sounds (increased motility)
Polyuria
Skeletal muscle weakness esp in extremities
edema

Back 57

Hyponatremia

Front 58

What can you do for a pt with hyponatremia?

Back 58

restrict fluid intake
daily weight
I/Os

Front 59

Assessment:
twitches and irregular muscle contractions
diminished deep tendon reflexes
thirst
dry mucous membranes
decreased urinary output

Back 59

Hypernatremia

Front 60

Normal potassium level

Back 60

3.5 - 5.1 mEq/L

Front 61

Assessment:
weak irregular pulse
muscle weakness
leg cramps
paresthesia
decreased deep tendon reflexes
nausea, vomitting, paralytic ileus
polyuria

Back 61

Hypokalemia

Front 62

How fast can you administer potassium IV?

Back 62

less than 20 mEq/hr; prefer 5-10

Front 63

Assessment:
weak irregular pulse
decreased BP
muscle twitches
paresthesia
nausea, vomiting, diarrhea

Back 63

Hyperkalemia

Front 64

Normal calcium levels

Back 64

9 - 11 mg/dL (serum level)
OR
4.5 - 5.5 mEq/L

Front 65

Assessment:
tingling of fingers
numbness around mouth
tetany, convulsions, muscle cramps
Hyperactive deep tendon reflexes

Back 65

Hypocalcemia

Front 66

Chvostek's sign (Cheek)
and
Trousseau's sign (T with fingers when using BP cuff)
are signs of which electrolyte imbalance?

Back 66

Hypocalcemia
Hypomagnesemia

Front 67

Assessment:
Increased BP
profound muscle weakness
diminished deep tendon reflexes
decreased GI motility
anorexia, nausea, constipation

Back 67

Hypercalcemia

Front 68

Normal magnesium level

Back 68

1.6 - 2.6 mg/dL

Front 69

Assessment:
rapid heart beat
increased BP
twitches
paresthesia
tetany, seizures
hyperreflexia

Back 69

Hypomagnesemia

Front 70

Assessment:
bradycardia
low BP
diminished deep tendon reflexes
skeletal muscle weakness

Back 70

Hypermagnesemia

Front 71

Vein inflammation associated with invasive procedures like IV placement.

Back 71

Phlebitis

Front 72

How do you treat phlebitis?

Back 72

apply warm moist packs

Front 73

Results from prolonged venous HTN, which stretches the veins and damages the valves

Back 73

venous insufficiency

Front 74

Venous or Arterial?
Brown discoloration along ankles

Back 74

Venous

Front 75

Venous or Arterial?
Ulcer - pink, uneven edges, granulation present

Back 75

Venous

Front 76

Venous or Arterial?
Intermittent claudication in buttocks or legs

Back 76

Arterial

Front 77

Venous or Arterial?
Gangrene

Back 77

Arterial

Front 78

Venous or Arterial?
Dependent rubor

Back 78

Arterial

Front 79

What is the classic symptom of PAD (peripheral artery disease)?

Back 79

Intermittent claudication

Front 80

ischemic muscle ache or pain that is precipitated by exercise and resolves within 10 minutes of rest

Back 80

Intermittent claudication

Front 81

Venous or Arterial?
Shiny, taut skin with hair loss

Back 81

Arterial

Front 82

Venous or Arterial?
Red, blue, or dusky when dependent

Back 82

Arterial

Front 83

Venous or Arterial?
Ulcers usually over bony prominences, on toes and feet

Back 83

Arterial

Front 84

Inflammation and thrombus obstruction of artery or vein, directly related to smoking

Back 84

Buerger's disease (thromboangitis obliterans)

Front 85

Episodic vasospasm of small cutaneous arteries of fingers and toes, associated with collagen diseases.

Back 85

Raynaud's phenomenon

Front 86

Three color changes - white, then blue, then red. Self-limiting, can be precipitated by cold, stress, caffeine, tobacco

Back 86

Raynaud's phenomenon

Front 87

How long do you receive anticoagulants after you have a DVT?

Back 87

3-6 months

Heparin bolus and then drip for up to 7 days

Front 88

Phlegmasia cerulea dolens

Back 88

swollen, blue, painful leg
very rare complication DVT in someone with advanced cancer

Front 89

What is the antidote for warfarin?

Back 89

Vitamin K

Front 90

INR:
normal and therapeutic level

Back 90

normal: 0.75 - 1.25
therapeutic: 2 - 3

Front 91

aPTT:
normal and therapeutic level

Back 91

normal: 24 - 36 seconds
therapeutic: 46 - 70 seconds

Front 92

What is the antidote for heparin?

Back 92

protamine sulfate

Front 93

How can you relieve the pain/discomfort of varicose veins?

Back 93

walking or elevating limb

Front 94

Why does chronic venous insufficiency lead to brown leg color?

Back 94

RBCs leak out into tissue and then get broken down

Front 95

Venous or Arterial?
Thick, hardened skin

Back 95

Venous

Front 96

Venous or Arterial?
Increased temp in ankle area

Back 96

Venous

Front 97

Which nutrients are most important for healing?

Back 97

protein, Vitamin A and C, Zinc

Front 98

Venous or Arterial?
Skin thin, delicate, dry, shiny

Back 98

Arterial

Front 99

Venous or Arterial?
Temperature gradient down the leg

Back 99

Arterial

Front 100

Injury to the tendons and ligaments

Back 100

Sprain

Front 101

Excessive stretching of the muscle, often involving the tendon

Back 101

Strain

Front 102

Avulsion fracture

Back 102

severe strain in which the ligament pulls loose a fragment of bone

Front 103

Use RICE for most musculoskeletal injuries. What does RICE stand for?

Back 103

Rest
Ice
Compression
Elevation

Front 104

When should you apply heat to a musculoskeletal injury?

Back 104

after 24 to 48 hours. Remember to leave heat on for a max of 20-30 minutes

Front 105

Subluxation

Back 105

partial dislocation

Front 106

CMS

Back 106

circulation
motion
sensation

Front 107

甘口

Back 107

/ sweet flavour/mildness/flattery/stupidity/

Hint 107

[あまくち]

Front 108

Patients who have the best outcomes after a joint replacement have this characteristic

Back 108

self-efficacy

Front 109

What is the most common reason for knee arthroplasty?

Back 109

debilitating pain

Front 110

After total knee replacement, which type of exercise would you begin on the first day?

Back 110

isometric quadriceps setting

Front 111

Following knee surgery, put this on the knee when putting pressure on the joint.

Back 111

Knee immobilizer