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254 Cards in this Set

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Normal Potassium Level
3.5-5.1
Normal Sodium Level
135-145
Osmolarity Plasma
270-300 mOsm
Electrolytes that pass via active transport
Sodium, Potassium, Calcium
Recommended daily fluid intake
2500 ml
Average daily urine output
1500 ml
Normal white blood cell count
4500-11000
Normal ESR
0-30 mm/hr
Normal Total Billirubin (adult)
< 1.5 mg/dl
Normal BUN
25 mg/dl
Normal fetal heart rate 1st trimester
160-170 bpm
Normal fetal heart rate at term
120-160 bpm
Therapeutic range for Magnesium Sulfate labs during treatment for preeclampsia
4-8 mg/dl
Position of client during paracentesis and rationale
Upright. allows intestines to flow posterior decreasing risk of perforation
Appearance of stool: Chrons Disease
Loose, no blood present
Kidneys require and receive ___% resting cardiac output
20-25%
Urinary analgesic used to treat pain associated with pylenophritis
phenazopyridine (Pyridium)
Body fluid is __% of weight in
Adults
Older Adults
Infants
Adults 60%
Older Adults 55%
Infants 80%
CO2 narcosis results when CO2 levels are >___.

Signs and Symptoms include
CO2 70
S/S: confusion, tremors, convulsions, coma.
Post-op TURP change in orientation or LOC most likely due to....____
Hyponatremia
acetylcystine (mucomist) is given po or ng to treat _____
given via nebulizer for _____
Tylenol toxicity
(give on empty stomach, mix with cola if given po)

Mucolytic
Medication given to treat iron overload
Deferoxamine
Four laboratory values that will increase with dehydration include...
Urine Specific Gravity
BUN
HCT
Sodium
Lithium toxicity can be by a lack of this electrolyte
Sodium

Decreased excretion of lithium
Muscle strength
0/5=_____
5/5=_____
0/5= paralysis
5/5= normal
Mantoux Test Positive result
High Risk >___mm
Gen Pop >___mm
High Risk >15mm
Gen Pop >10mm
A decreased protein diet is recommended in kidney failure because......
BUN and Creatinine are byproducts of protein metabolism
Normal WBC count
4500-11000/mm3
Neutrophil count
56% or 1800-7800
Phosphorus
2.7-4.5 mg/dl
acetylcystine (mucomist) is given po or ng to treat _____
given via nebulizer for _____
Tylenol toxicity
(give on empty stomach, mix with cola if given po)

Mucolytic
Medication given to treat iron overload
Deferoxamine
Four laboratory values that will increase with dehydration include...
Urine Specific Gravity
BUN
HCT
Sodium
Lithium toxicity can be by a lack of this electrolyte
Sodium

Decreased excretion of lithium
Muscle strength
0/5=_____
5/5=_____
0/5= paralysis
5/5= normal
Mantoux Test Positive result
High Risk >___mm
Gen Pop >___mm
High Risk >15mm
Gen Pop >10mm
A decreased protein diet is recommended in kidney failure because......
BUN and Creatinine are byproducts of protein metabolism
Normal WBC count
4500-11000/mm3
Neutrophil count
56% or 1800-7800
Phosphorus
2.7-4.5 mg/dl
Normal Magnesium level
1.6-2.6 mg/dl
Normal Calcium level
8.6-10 mg/dl
Normal Creatinine level
0.6-1.3 mg/dl
Minutes to hold pressure following venipuncture to

Radial Artery
Femoral Artery
5 min radial
10 min femoral

More if necessary
Electrolyte imbalance that causes flat or inverted T waves and/or prominant U waves
Hypokalemia (<3.5)
Normal CVP
4-11 cm H20
Foods high in Calcium (8)
Cheese
Collard Greens
Milk/soy Milk
Rhubarb
Sardines
Spinach
Tofu
Yogurt
Foods High in Potassium (15)
Avocado (1097mg)
bananas, cantalope, oranges
mushrooms, carrots (341mg), potatos, pork, beef, veal, raisins, strawberries, fish, spinach(470mg), tomatos
Foods containing Tyramine (7)
yogurt, aged cheese, raisins, figs, smoked/processed meats, red wines, avocados
Normal Phos level
2.7-4.5

(invertation to calcium level)
Normal Magnesium Levels
1.6-2.6 mg/dl
Normal Creatinine Level
0.6-1.3
Normal Calcium Level
8.6-10 mg/dl
When giving potassium IV NEVER exceed ____mEq/hr
20 mEq/hr
Live virus vacc.
Not given during pregnancy
SC route
Made from duck eggs
Avoid immunosupressed
Breastfeeding safe
Rubella
In hyponatremia bowel sounds will be....
Hyperactive
Addison's Disease has an increased risk for hyperkalemia. name two conditions that increase the risk of hypokalemia (hint both start with C)
Cushings

Colitis
This med facilitates K+ excretion via the GI tract
Kayexalate
Stools expected with cystic fibrosis..
large, bulky, foul smell, fat streaked (steatorrhea)
Yellow stools indicate
Liver/gall bladder problems
Green stools may indicate
rapid transit or infection
End stage renal disease is expected ____yrs after the onset of proteinuria in DM. regardless of diabetic control
5-10 years
According to Mosby a unit of Packed RBCs is ___cc
250cc
Chorionic villi sampling will be conducted when during gestation
8-12 weeks

Testing for genetic disease
Ultrasounds are usually conducted ____weeks of pregnancy
18-40
Amniocentesis is performed in the ___ trimester to evaluate ________
3rd trimester
evaluate fetal lung maturity
Fetoscopy can be performed to directly observe fetus or obtain skin/blood sample. most often it is performed at about ____ weeks
18 weeks
Erickson:

Trust vs Mistrust
Erickson: Infancy

Others and Environment
Erickson:

Autonomy vs Shame
Erickson: Toddler

Environment and self esteem
Erickson:

Initiative vs Guilt
Erickson: Preschool

initiates activities, sexual awareness
Erickson:

Industry vs Inferiority
Erickson: School Age

(self worth by refining skills)
Erickson:

Identity vs Role Confusion
Erickson: Adolescent

(integrate roles, self image)
Erickson:

Intimacy vs isolation
Erickson: Young Adult

(commitments, personal)
Erickson:

Gerativity vs Stagnation
Erickson: Middle Aged

(career, family, achievements)
Erickson:

Integrity vs Despair
Erickson: Older Adult

(accomplishment in life, upcoming death)
Foods Rich in Phosphorus (7)
Fish, organ meats, nuts, pork, beef, chicken, whole grain breads and cereals.
Foods Rich in Magnesium (14)
Pork, beef, chicken, tuna, avocado, cauliflower, green leafy, peas, potatos, raisins, yogurt, milk, oatmeal, peanut butter
Hypersensitivity Reactions

"wheal-and-flare"
Hypersensitivity Reactions

Type 1
Hypersensitivity Reactions

hematuria
Hypersensitivity Reactions

Type 2
Hypersensitivity Reactions

High Fever
Hypersensitivity Reactions

Type 3
Hypersensitivity Reactions

Contact Dermatitis (delayed)
Hypersensitivity Reactions

Type 4
ABGs

pH
ABGs

7.35-7.45
ABGs

PCO2
ABGs

35-45
ABGs

HCO3-
ABGs

22-27 mEq/L
ABGs

PO2
ABGs

80-100
Electrolytes

3 main intracellular
Electrolytes

potassium, magnesium, phosphorus
Electrolytes

3 main extracellular
Electrolytes

sodium (mainly), chloride, calcium
S/S air embolism (6)
Chest pain, dyspnea, hypoxia, anxiety, tachycardia, hypotension.
IV lasix should be given at a rate of ____min per _____mg
1-2 minutes per 40 mg
Foods rich in Vitamin K
Green leafy veggies, fish, liver, coffee, tea
Normal Hematocrit Male
39-52%
Fetal movement is normally felt at
___weeks nulliparous
___weeks multiparous
18 weeks nulliparous

14-16 weeks multiparous
Signs of hypocalcemia
decreased HR, pulses, and B/P

ECG: ST and QT prolongation
Painless third semester vaginal bleeding may be a result of
Placenta Previa
Painful bleeding with uterine contractions and boardlike abdomen may be signs of an emergency known as
Abruptio Placenta
early decelerations are normal during labor as a result of
compression of head
Diet teaching for Menieres Disease include...
Low Na, no caffeine, no sugar, no monosodium, no glutamate, no ETOH.
Electrolytes

U waves may indicate
Electrolytes

hypokalemia
Lab Values

Normal Platelet Count
Lab Values

150,000-400,000
Lab Values

Normal RBC Count
Lab Values

4-6.2 millon
Lab Values

Used to monitor Heparin therapy
Lab Values

aPTT used to monitor...
Lab Values
Lab Values

aPTT Value usually...

Therapeutic for Heparin
Lab Values
Lab Values

20-36 seconds

1.5-2.5X norm (heparin)
Lab Values

PT
INR standard therapy
INR high dose
Lab Values
9.6-11.8 (male)
9.5-11.3 (female)
2.0-3.0 (warfarin)
3.0-4.5 (high-dose warfarin)
Lab Values

Clotting Time
Lab Values

8-15 minutes
Lab Values

RBCs
female
male
Lab Values

female: 4-5.5
male: 4.5-6.2
Lab Values

Hgb
male
female
Lab Values

male: 14-16.5 g/dl
female: 12-15 g/dl
Lab Values

Hct
Male
Female
Lab Values

male: 42-52%
female: 35-47%
Lab Values

CK levels begin to rise ___ hrs of muscle damage, peak at ___18hrs and returns to normal in __to___ days
Lab Values

6 hrs
18hrs
2-3 days
Lab Values

Normal CK value
Lab Values

26-174 units/L
Lab Values

Isoenzymes
CK-MB=
CK-MM=
CK-BB=
Lab Values

isoenzymes
cardiac muscle
brain tissue
skeletal muscle
Lab Values

LDH levels begin to rise ___hrs after MI and peaks __to ___hrs, returns to normal in __to ___ days.
Lab Values

24hrs, 48-72 hrs, and 7-14 days.
Lab Values

Presence of and LDH flip is helpful in diagnosing MI this occurs when. ..
Lab Values

LDH1 is higher than LDH2
Lab Values

This indicator of MI should be repeated for three consecutive days.
Lab Values

LDH
Lab Values

Troponin levels elevate __ hrs after MI

Trop-I may remain elevated for _____days

Trop-T may remain elevated for
_____ days
Lab Values

3hrs
I 7-10 days
T 10-14 days
Lab Values

Troponin I >___ indicates MI

Troponin T >___ indicates MI
Lab Values

Trop I: >1.5 ng/ml

Trop T: >0.1-0.2 ng/ml
Lab Values

Trop levels drawn q12 hrs times ___ and then daily for ____ days
Lab Values

Q12 times 2
Daily 3-5 days
Lab Values

Myoglobin level
Lab Values

< 90 mcg/L (non specific to cardiac muscle but peaks early as soon as 2 hrs after injury)
Lab Values

Albumin Level
Lab Values

3.4-5 g/dl
Lab Values

Ammonia levels important to refrain from ____ prior to draw
Lab Values

Smoking can alter ammonia levels
Lab Values

Amylase levels increase in acute pancreatitis ___-___ hrs after the onset of pain, peaks about ____hrs and returns to normal ___-___days after onset of pain.
Lab Values

3-6hrs
24hrs
2-3 days
Lab Values

Amylase Level
Lab Values

25-151 units/L
Lab Values

Amylase or Lipase values rise first
Lab Values

Amylase
Lab Values

Total Bilirubin
Lab Values

<1.5 mg/dl
Lab Values

Normal Total Cholesterol
LDLs
HDLs
Triglycerides
Lab Values

140-199
<130
30-70
<200
Lab Values

Protein
Lab Values

6.0-8/0 g/dl
Lab Values

Glycosated Hemoglobin (A1c)
Lab Values

Good Control <7%
Fair Control 7-8%
Poor Control >8%
Lab Values

Serum Creatinine level
Lab Values

0.6-1.3 mg/dl
Lab Values

BUN level
Lab Values

8-25 mg/dl
Lab Values

"shift to the left" is an increased number of immature _________ as a result of _________ or ___________.
Lab Values

Neutrophils

Bone marrow response to overwhelming infection or inflammation.
Lab Values

CD4
norm
compromised
severe immune prob.
Lab Values
>500
200-499
<200
Urine SG

norm.
Urine SG

1.016-1.022
leflunomide (Arava) given to treat...
RA (antiinflammatory)
Vitamin K foods....(5)
Green Leafy, fish, liver, coffee, tea
ECG

Prolonged ST or Prolonged QT may be a sign of
ECG

Hypocalcemia
ECG

Shortened ST seg or widened T wave may be a sign of...
ECG

Hypercalcemia
ECG

Tall peaked T waves, Flat P waves, widened QRS or prolonged PR interval may be a sign of...
ECG

Hyperkalemia
ECG

ST depression, shallow flat or inverted T wave, prominent U wave may be a sign of
ECG

Hypokalemia
ECG

Tall T waves, Depressed ST segment may be a sign of
ECG

Hypomagnesemia
ECG

Prolonged PR interval, widened QRS may be a sign of
ECG

Hypermagnesemia
PSYCH

In dealing with a patient with paranoid beliefs do not... (3)
support
argue
criticize
Rx

cyclosporine (Sandimmune)
Rx

Immunosuppressant
prevent organ rejection
tx psoriasis
tx arthritis
Rx

azathioprine (Imuran)
Rx

immunosuppressant

taken for life after transplant
Rx

Ticlopidine Hcl (Ticlid)
Rx

Platelet aggregation inhibitor
Rx

busulfan (Myleran)

adverse effect...
Rx

antineoplastic used to supress bone marrow in CML and AML

Pulmonary Toxicity (NP cough, crackles, tachypnea, dypnea)
OB/GYN

uppermost section of uterus is referred to as the...
OB/GYN

Corpus
LABS

Amylase peaks ___hrs and then back to normal in ___-___ hrs.
LABS

24hrs
48-72 hrs
Cushings Triad
Increased ICP

Increase SBP
Widened PP
Decreased HR

Abnormal Respirations
Glasgow Coma Scale
normal: ___
assesses
_____
_____
_____
15 best

Eye Opening (4best)
Verbal Response (5 best)
Motor Response (6 best)
osmotic diuretic used to treat IICP
mannitol 25%
Keh'r Sign
Right shoulder pain r/t liver problem
LUQ pain r/t
gastric ulcer
RUQ pain r/t...
gallbladder
Middle upper abdominal pain r/t
acute gastritis, small bowel obstruction or pancreatitis
Decorticate Posturing
rigid flextion r/t damage to regions above brainstem in corticospinal tracts
Rx

HistamINE receptor blockers (H2 blockers)

name 4
function
cimetidine (Tagamet)
rantidine (Zantac)
famotidine (Pepcid)
nizatidine (Axid)

block receptors that are responsible for acid secretion in stomach
Rx

PPIs

name 5
function
omeprazole (Prilosec)
esomeprazole (Nexium)
iansoprazole (Prevacid)
pantoprazole (Protoxix)
rabeprazole (Aciphex)

blocks pumps within acid secreting cells decreasing stomach acid.
Rx

common Med given to increase cerebral perfusion...
Dopamine

(sympathomimetic increases HR and B/P)
Meningeal layers starting with the outermost.. including spaces
Skull
DURA
Dura
subdural space
ARACHNOID
subarachnoid space
PIA
brain
Cranial Nerves

Pupillary reflex assesses cranial nerves ___ and ___. and tests if pupils __________.
2- optic
3- oculomotor

React to light
Rigid extension r/t lesions of the brainstem...
decerebrate positioning
Peyer Patches
small intestine

congregation of T cells
Therapeutic Digoxin Level
0.8-2 ng/ml
mineralcorticoids such as androgens are secreted from the...
adrenal cortex
cortisol is a ...____corticoid
glucocorticoid
Catecholamines such as epinephrine and norepinephrine are secreted from the....
adrenal medulla
the pulling force by plasma proteins is referred to as..
oncotic pressure
"Shift to the Right"
increased # of immature neutrophils..

pernicious anemia or cell break down.
HHNS is a type 2 DM syndrome and stands for...
hyperglycemic
hyperosmolar
nonketotic syndrome
administration of aluminum hydroxide (Alu-caps) includes...
Antacid...

chew first and then follow with 8oz H2O.. can cause constipation.
acarbose (Precose)

tx

four contraindications
oral antidiabetic

do not give to patients with kidney disorders, IBS, colitis, or partial bowel obstruciton.
Down syndrome: bruising may be due to an increased risk for....
leukemia
Hepatitis

preicteric phase
fatigue, nausea, cough and joint pain
Hepatitis

icteric phase
RUQ pain, jaundice, dark urine, clay stools, pruritis
Hepatitis

posticteric phase
jaundice decreasing, urine and stools returning to normal, appetite returns.
Normal Intraocular Pressure
10-21
Gastric secretions with a pH less than ____ need to be treated with antacids
5
Three ways to facilitate outflow during peritoneal dialysis...
increase HOB
COP side to side
Gently massage ABD
permanent peritoneal catheter is called ...
Tenckhoff catheter
Cleft pallate repair occurs...
6-18 months of age
Cleft Lip repair occurs...
6 weeks to 12 weeks
Assess skin turgor on adult
below clavicle or on abdomen
assess skin turgor on a child
on the fleshy part of arms or legs
Give Lente insulin _____ before meals
30-60 minutes

intermediate acting
Give Regular insulin ____ before meals
15-30 minutes
Give insulin Lispro ______ before meals
Immediately
Rx

carbamazepine (Tegretol)

given for.....(3)
adverse effects (5)
anticonvulsant, antimanic, antipsychotic

aplastic anemia
bone marrow suppression
rash
photosensitivity
stevens-johnson syndrome
Most common CA in woman
Cervical Cancer (uterine cervix)
PPD

Healthy Child
HIV, Imm. Comp. or exposure
<4 chronid disease, exposure, or foreign country
15mm

5mm

10mm
Prolonged bleeding and bruising without petichiae may be...
hemophilia
3 checks before magnesium sulfate administration
UOP >30ml
RR >12
DTRs= 2+
cyclosporine
powerful immonosuppressant

nephrotoxic!!
increases BG
infection risk
tremors
hirsutism
Nageles Rule
back three months add one week from last menstrual period for due date.
Right atrium location
right midaxillary fourth intercostal space
takes this long for synthroid levels to become therapeutic
at least one month
Dysequilibrium Syndrome
rapid change in ECF causing decreased osmolarity in blood after hemodialysis.

n/v, confusion, restless, headache, twitching, jerking, decreased B/P and seizures.
After kidney transplant for ___hrs IV therapy rate is based on...
12-24 hrs

urine output
Vaccines not given until 12-15 months of age
MMR and Varicella
Immunizations contraindicated in immunosuppressed clients. (3)
oral polio
MMR
varicella
T-tube drainage expected to stop in ___days
3-5
Early drug of choice to treat rheumatoid arthritis is
aspirin
Three causes of type 2 Diabetes
insulin resistance
insulin deficiency
inappropriate glucose production by the liver

beta cells of pancreas can't keep up with insulin demands in insulin deficiency.
Oral contraceptives are contraindicated for...
woman smokers 35 years or older
Drugs to treat a headache related to cirrhosis
aspirin, naproxen, ibuprofen
decreased sodium may cause the bowel sounds to be
hyperactive
allergic to eggs do not get ____vaccine.
rubella
nitrofuratoin (Macrodantin)
antibacterial (UTI tx and prophylaxis)

tx: 50 mg tid or qid
proph: 50 mg hs daily
Facial swelling
Tongue swelling
Hives
Skin pain
A red or purple skin rash that spreads within hours to days
Blisters on your skin and mucous membranes, especially in your mouth, nose and eyes
Shedding (sloughing) of your skin
Stevens-johnson syndrome
Achlorhydria or the absence of hydrochloric acid in the stomach is a clinical finding of
Gastric Cancer
Head in alignment with no support occurs at ...
4-5 months of age
Sitting Steadily unsupported...
8 months
Turning from back to abdomen....
6 months
loss which is not or can not be openly expressed and acknowledged by others
Disenfranchised grief
HIV not wanting to tell partner what is RN responsibility
counsel as to ethical responsibility of pt. to tell
POA responsibly for carrying out...
Living Will
intermittent claudication is relieved with _______ and a sign of _____disease
Rest
PVD
_______ and _______medications are not ototoxic. _________are ototoxic.
Penicillin and cephalosporin

Aminoglycosides
thinking that someone is after him for something he didn't do is an example of
persecutory hallucinations
(HELLP) syndrome stands for..
hemolysis (H), elevated liver enzymes (EL), and low platelet count (LP)
normal ankle:bracial ratio
1:1 ( or ankle slightly higher, if ankle lower esp. after exercise may indicate PVD)
Pheochromocytoma is a ___________producing tumor that arises from the cells of the adrenal _______and sympathetic ganglia. It causes _______________by releasing excessive amounts of ____________.
catecholamine-
medulla
increased blood pressure
norepinephrine;
Dopamine (Intropin) at low doses increases ______ _____ at intermediate doses, it increases ________ ________, at high doses, it causes _______ and __________ __________.
renal perfusion
myocardial contractility
vasoconstriction and ventricular dysrhythmias
Dobutamine (Dobutrex) is usually given in conjunction with _________ because it has a vasodilation effect, improves cardiac output, and is less likely to cause dysrhythmias.
dopamine
First sign of puberty in males
testicular enlargement
Role play teaching is appropriate for this age
School aged
T-tubes functions
drain from common bile duct following surgery.
headache and epigastric pain are precursors of
impending seizure (preeclampsia)
when evacuating clients in emergency who goes first...
most ambulatory
Gangrenous wounds and diminished peripheral pulses are associated with ....
arterial occlusive disease.
Heparin Antagonist
Protamine Sulfate
congested lung should be ____ to facilitate drainage
UP, use gravity to assist..
An Addisonian crisis is an acute episode of ________ __________.
adrenal insufficiency,

weakness, often accompanied by pain in the back, abdomen, or legs, along with severe manifestations of glucocorticoid and mineralocorticoid deficiency including hypotension (particularly postural), tachycardia, dehydration, hyponatremia, hyperkalemia, hypoglycemia, hyperpyrexia, and confusion. It is treated by administration of hydrocortisone and fluid replacement.
The most common side effects of benztropine (Cogentin) are

(taken for Parkinsons)
anticholinergic

constipation and urinary retention.
Drug that blocks the action of the parasympathetic nervous system
Anticholinergic
"hot as hades, blind as a bat, dry as a bone, mad as a hatter." is a simile to remember signs of ...
Cholinergic Crisis (overdose of an anticholinergic)
Most important when obtaining comprehensive medical history
place events in chronological order.
7 cardinal movements of the mechanism of labor in order...
Engagement, Descent, Flexion, Internal rotation, Extension, External rotation (restitution), Birth by expulsion.
RhoGAM or RhoD will be given when...
28th week of pregnancy and after each pregnancy

titer decreases within months not a permanent fix..
mediastinal structures to swing back and forth with respiration.
Flail Chest with Mediastinal Flutter
This results from pressure on the mesenteric artery and can lead to intestinal obstruction.
Cast Syndrome
If a chest tube becomes disconnected, the nurse should
as quickly as possible place the end of the tube in a container of sterile water or saline until the drainage system can be replaced.
The therapeutic PT for a client receiving warfarin is ______ the normal
1.5 times
PT norm
9.5 to 11.5 seconds
impairment to watch for in children who have had cleft palate repair...
hearing loss
The Reed-Sternberg cell is found in
Hodgkin's disease.
Verapamil is a calcium channel–blocking agent that may be used to treat . . .
rapid-rate supraventricular tachydysrhythmias such as atrial flutter or atrial fibrillation.
The normal BUN level ranges from
8 to 25 mg/dL
NPH is an ________-acting insulin and peaks in approximately _______ hours.
intermediate
6 to 12
abnormal ectopic beats originating in the ventricles. characterized by an absence of ___waves, presence of wide and bizarre ______ ______, and a compensatory ______ that follows the ectopy.
PVCs
P
QRS complexes
pause
danger for cystic fibrosis and hot weather
loss of salt through sweat.. salt substitutes are recommended.
what is ortolani's sign?
hip click when abducting hip during newborn assessment (dislocation).
urine should be acidic or alkaline to prevent infection?
acidic
disease of inflammation affecting synovial joints most often in middle aged women.
Rheumatoid Arthritis
erythromyacin eyedrop ointment at birth prevents blindness caused by...(2)
chlamydia trachomatis

gonococcal organisms
infants are obligatory ______ breathers except when ______
nose

crying