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82 Cards in this Set
- Front
- Back
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The exchange of O2 and CO2 between alveoli and blood.
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External respiration
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The exchange of O2 between blood and cells
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Internal respiration
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This adventitious breath sound sounds like hair being rubbed together.
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Friction Rub
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When the semilunar valves close you hear this heart sound...
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S2
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CO=
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HRxSV
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Normal Ejection Fraction
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50%-70%
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Normal Stroke Volume
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70ml
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Normal Cardiac Output
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4-8L/minute
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The ability of the heart to adjust to changing needs for CO
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Cardiac Reserve
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The CO adjusted for body size
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Cardiac Index
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SA node generates an impulse___ /min
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60-100
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The AV node generates an impulse __/min
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40-60
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Where you will usually find the PMI
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midclavicular line, 5th intercostal space
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How should you document the pulse of a pediatric patient?
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Record the activity during the reading.
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The downside of biological heart valve replacements...
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Need frequent replacement
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The downside of mechanical valve replacements...
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Need lifetime anticoagulant therapy
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The test for strep antibodies
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ASO titer
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Antibiotics may be given prophylactically for up to 10 years in patients with this disorder.
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Rheumatic Heart Disease
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In a patient with Infective Endocarditis, you must get these before you begin antibiotics...
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blood cultures
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Sudden cardiac death is sometimes the first sign of this disorder
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Hypertrophic cardiomyopathy
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After a CABG, sterile dressing changes should be done for the first___
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48 hours
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A symptom of HF, the heart chambers dilate
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Ventricular Remodeling
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Another result of heart failure, the cardiac muscle cells enlarge and eventually become stiff and non compliant
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Ventricular Hypertrophy
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The greater the stretch, the greater the force of the contraction
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Frank-Starling Mechanism
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fatigue, activity intolerance, dizziness, syncope, dyspnea, SOB, cough, orthopnea, inspiratory crackles and wheezes in the lung bases, S3 gallop
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S&S of left sided heart failure
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Your patient awakes at night and complains of being SOB. You know he has...
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paroxysmal nocturnal dyspnea
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When a client has a new central line, you always...
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Obtain a chest x-ray before infusing any fluids
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Normal CVP
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2-8 mmH2O
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Normal PAWP
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8-12mmHg
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Normal PAP
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Mean 15mmHg
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The client must have pliable plaque to be eligable for this...
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PCR, PTCA, Stent placement
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Indigestion, heartburn, nausea and vomiting.
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Signs of an MI for females.
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After an MI, the client will be on bedrest for ___
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12 hours
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The hallmark sign of pulmonary edema
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pink frothy sputum
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You are seeing a child in the ER who is having an asthma attack. You can hear him wheezing from the nurses station and suddenly, you don't hear him anymore. What do you do?
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Go check on him immediately. Decreasing symptoms can mean a worsening of the condition.
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Characteristics of someone with chronic bronchitis, a "blue bloater"
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cyanosis, obesity, edema, right sided heart failuer, productive cough, respiratory acidosis, sleep apnea, loud rhonchi and wheezes
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Characteristics of someone with emphysema, a "pink puffer"
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absent or mild cough, scant clear sputum, barrel chest, thin and cachectic, diminished breath sounds, tripod position
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Normal range of pH for ABGs
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7.35-7.45
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Normal range of PaCO2
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35-45
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Normal range for HCO3
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22-26
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Normal range for PaO2
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80-100
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ABGs:
pH 7.28 PaCO2 49 HCO3 28 PaO2 96 What is this client experiencing? |
Respiratory acidosis
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The only thing that causes Respiratory Alkalosis is....
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hyperventilation
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A client presents with weakness, fatigue, headache, malaise, anorexia, nausea, vomiting, abdominal pain, Kussmaul's respirations and flushed skin. What do you suspect?
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Metabolic Acidosis
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What should you do for a client in metabolic acidosis?
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Monitor V.S. and ECG, Maintain fluid replacement, assess for edema, check urine output hourly, daily weights, and frequently reorient
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Interventions for Respiratory Acidosis
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Raise HOB, O2, pursed lip breathing, reposition and ambulate, encourage fluids, chest physiotherapy
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Interventions for Respiratory alkalosis
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Reassure client, encourage slow breathing, breathe into an oxygen mask or a paper bag
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Manifestations of PE
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abrupt onset, dyspnea, chest pain, anxiety, cough, tachycardia, tachypnea, low grade fever, sense of impending doom
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A client with a suspected PE goes down for a lung scan. Why?
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To confirm the PE.
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What surgery might be done for a client with a PE?
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Placement of a filter in the inferior vena cava to catch large emboli
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A confused client is walking down the hallway holding his chest tube apparatus above his head and saying, "I am the king of this ward!!" What is your first action?
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Bring the chest tube down below his chest and check that all seals are still intact.
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This is the test that diagnoses cystic fibrosis.
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Sweat Test
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Some interventions for CF
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extra protein and calories, liberal fluids, pancreatic enzymes with meals, chest physiotherapy twice daily, give bronchodilators as ordered.
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A total laryngectomy removes...
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the entire larynx, the epiglottis, thyroid cartilage, and several tracheal rings
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Remember the amount of O2 delivered by these methods: nasal cannula, face mask, nonrebreather, and a Venturi
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Nasal cannula 24-45%
Face mask 40-60% Nonrebreather up to 100% Venturi 24-50% |
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What is special about a Venturi mask?
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Can be set to a very specific amount of O2 to be delivered.
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A person with pneumonia should be drinking _________ of fluid/day
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2500-3000mL
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Which test provides a definitive diagnosis for TB?
a) sputum smear b) liver function test c) pulmonary function test d) sputum culture |
d) sputum culture
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A homeless man positive for TB returns to the ER after receiving no meds and no treatment for 2 months. In regards to public safety, what should the nurse do?
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Report him to the health department.
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cramping or aching pain in the calves, thighs or buttocks, relieved by rest
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intermittent claudication
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thin, shiny, hairless skin on the lower legs indicates...
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arterial insufficiency, PVD
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Lupus is diagnosed with this test
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Anti-DNA antibody testing
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A client with a recent above the knee amputation of his left leg wants to keep it elevated on the pillow all the time. You know that you must teach him...
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Elevating the stump all the time can lead to contractures and long term reduced mobility.
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You teach a client with osteoporosis to...
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take calcium and vitamin D supplements, get exercise, and stop smoking
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The abnormal hemoglobin in people with sickle cell disease is called?
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HgbS
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You see a new nurse telling a mother of a child in a sickle cell crisis that perhaps an ice bag would help the pain. Later, you pull her aside and tell her...
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Cold would increase the pain by causing more vasoconstriction. Heat, on the other had, can be helpful.
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This type of lymphoma has Reed Sternberg cells in the lymph nodes...
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Hodgkins
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This type of lymphoma does not have Reed Sternberg cells....
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Non-Hodgkins
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Hemophilia A is transferred how?
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from mother to son
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The priority problem for a hemophiliac is...
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safety!
Risk for injury |
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The nurses #1 priority with a fracture is...
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immobilization of the joint
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Petichiae rash on the chest in a child with a broken femur may indicate...
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fat embolism
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The usual treatment for a hip fracture is...
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surgery: replacement or fixation
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These two things are given to treat Kawasaki Disease
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gamma globulin and aspirin
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A child with Kawasaki disease is crying and swings his arms every time you go to get v.s. The mother says "I'm so embarassed. He knows better than to act like this. I don't understand." What do you teach her?
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irritability is the hallmark sign of KD
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A mother comes into the ER with her 6 year old boy who was hit in the face with a baseball and developed epistaxis. She has him holding his head back with a warm washcloth over his nose. What do you teach her?
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The child should lean forward and pinch the soft part of the nose. The warm cloth will actually increase the bleeding and tilting the head back will keep the blood in the nasal passages.
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45 minutes later, the child with the baseball nosebleed is still bleeding. What do you suspect?
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A bleeding disorder
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You are doing rounds and you notice your client with a central venous catheter has puffy eyes and swollen arms. What may be going on?
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Superior Vena Cava Syndrome
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A client comes back from a bronchoscopy and the first thing he asks is to order a tray. What do you tell him?
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You must wait until we are sure that your cough and gag reflexes have returned.
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These are interventions to prevent rupture of an aneurysm
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bed rest with the legs flat, calm environment, prevent straining
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Thrombocytopenia is diagnosed when there is a platelet count of....
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less than 100,000
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This medication is the most commonly used drug in a hypertensive crisis
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Nipride (sodium nitroprusside)
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