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258 Cards in this Set
- Front
- Back
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Hyperthyroidisim is aka
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Graves disease
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Why is Inderal used in the management of cirrhosis
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to prevent bleeding from esopheal varicess
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s/s most characterstic of acute pyelonephritis
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flank pain
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A pt with hypothyroidism who is taking hormone replacement therapy may be at risk for
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hyperglycemia
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following a thyroidectomy asses for bleeding by
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asking the pt --Do you have a feeling of fullness at the incision site
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Priority intervention for pt with hyperthyroidism who started on inderal
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monitor pulse and pulse pressure
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On synthroid therapy how long to achive full effect
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10 days
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What diet for Graves disease
and what should be provided |
high calorie diet with increased carbs,protien and vit. supplements and a quite environment
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Physiological effect of T4
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increased neuromuscular response
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clinical manifestations of hyperparathyroidism
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fatigue
muscular weakness/poor muscle tone renal calculi cardiac arrhythmias |
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what causes fatigue in hyperparathyroidism
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calcium concentrating in blood stream
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Priority intervention for pt during Thyroid storm with a NSG diagnosis of altered body temp
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apply a hypothermia blanket
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What is pheochromocytoma
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a tumor of the adrenal gland
which produces catecholamines(epinephrine and norepinephrine) |
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How is pheochromocytoma cured
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surgery
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Pheochromocytoma causes
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HTN-- and if HTN is untreated can lead to stroke
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Older pt's with hyperthyroidism commonly present with what
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diffuse puritus
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Intervention likely to enhance the comfort of a pt with hyperthyroidism
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provide a cool environment
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Decreased Erythropoetin secondary to end stage renal disease(ESRD) causes
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SOB
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Pt with adrenal insufficiency is dizzy and experiencing neuromuscular irritability and confusion what lab finding would you expect
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hyponatremia
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s/s of Graves
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Nervousness,irritabily, hand temors,insomnia,heat intolerance, pyrexia, amenorrhea, tachycardia, palpitations, goiter, exphthalmos
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What type of pt is at risk for gallstones
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obese and women are 4x's more likely to get gallstones than men
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What is the antidepressant effect
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mood elevator
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monitor pt with end stage cirrhosis of liver for
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ascites
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what lab value will be elevated in cirrhosis of the liver
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ammonia
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Primary dx for pt with anorexia
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altered nutrition less than bodys requirements
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what should be measured when assesing a pt with liver cirrhosis
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abd girth
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position for pt with severe acites
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fowlers
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pt with acute renal failure possible clinical manifestion
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metabolic acidosis
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Erickson developmental stage for a 10 year old
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industry vs inferiority
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signs found in pt with HEP A
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dark urine,clay colored stools, yellow skin
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before a 24 hr VNA test is collected what should be restricted
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caffeine
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Diet for Glomerulonephritis
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low protein
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glomerulonephritis affects who
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school age children--males more than females
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causes of glomerulonephritis
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occurs 1-2 wks after resp. infection post streptococcal infection
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What causes anemia in pts with chronic renal failure
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decrease erythropoetin production by the kidneys
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appropriate nsg dx for a pt with exothalmus
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body image disturbance
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What clinical sign do you expect to see in a pt who has a high level of vassopressin
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edema
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non-pharmacological pain management for sickle cell crisis
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apply heat
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nursing intervention for MILD hypothyroidism
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promote activity
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Pt is hypervigilant and has dejavu these are signs of
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post traumatic stress disorder
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bulima is
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binge eating
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In diabetes Insipidus the urine specific gravity is
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1.001-1.005
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What should be kept in pt's rm after a thyroidectomy
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trach set
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Why give Lugols solution prior to thyoidectomy
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to devasculaize the gland
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In corticosteroids therapy the plan of care is to
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prevent infection
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prior to an IVP the nurse needs to ask
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do you have any allergies
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Buffalo hump is an abnormal adipose tissue distribution in what disease
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cushings syndrome
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What med serves as replacement therapy in hypothyroidism
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synthroid
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a hormonal change of adolescnce from adrogenic stimulation of sebum production is a predisposing factor for
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acne vulgaris
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Why should synthroid NOT be taken with food
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food interferes with absorption
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Tofranil with concomitant use may lead to
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GI complications
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a pt on Synthroid should report what
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tachycardia
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s/s of hyperkalemia
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muscle weakness, hypotension, shallow respirations, anoxeria
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s/s of hypokalemia
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bradycardia, oliguria and muscle cramps
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A pt who has good control of diabetes may show a
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2 hr post prandial blood sugar result of 139
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A pt with hypothyroidism has what type of intolerance
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cold--give blanket
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DM pt should care for feet how
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bath feet with warm water and dry escpecially btn toes --ck feet daily
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21 yr old is getting married and states unsure if they want to go thru with it what is this called
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Intimacy vs isolation
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The Psychosocial state of development in alcoholism is
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oral
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clinical manifestiations of acute pancreatitis
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constant epigstic pain, abd pain that radiates in to back, flank pain which is more intense in the supine position
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If a pt has a postitive out look on surgery what goal has been met
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self actualization
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What lithum side effects should be reported immediately
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diarrhea, vomiting, drowsiness weakness,lack of coordination
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Theraputic level for lithium
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0.6- 1.2
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What type of disorder is OCD
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anxiety related
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alanon is a help group for
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families of alcoholics
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The treatment for a phobia is
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desensitization
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position of pt after ECT
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on side or with head turned to side
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what is given before ECT
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Atropine to inhibit salivation and respitatory secreations to minimize the risk of aspiration
NPO 6-8 HRS PRIOR TO ECT |
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how should trazadone be taken
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with a meal or snack and at bed time
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endogenous depression is
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depression comming from with in the person and is biochemical
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reactive depression is
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depression caused by the occurance of something
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paxil should be taken
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with food and NOT at bedtime
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Delusion is
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a fixed false belief
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giving away personal posseseions is a tell-tell sign of
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sucide ideation
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agoraphobia is
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the fear of open, crowded spaces
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a personality disorder that manifest hostilities onto others is
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paranoid
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a long term complication of DM is
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diabetic neuropathy
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deep rapid respirations are
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kussmal
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The most important factor predisposing to the develpoment of type 2 DM is
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obesity
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diet for Lithum therapy
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adequate sodim and intake of fluids 2500 to 3000mls
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A doctor pronounces a child dead and the mother continues CPR --what is mom showing
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denial
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what is transvestitism
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the desire to wear the opposite sexs clothes
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portal vein HTN is associated with
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liver cirrhosis
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After thyroidectomy assess for laryngeal damage that is manifested by
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hoarsenesss
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A pt with hypoparathyroidism will have
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decrease calcium
increase phosphorous |
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What meds are given to counteract extrapyramial side effects
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artane and cogentin
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In order to prevent a HTN crisis and headache what foods should be avoided while taking a MAOI
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aged cheese, beer, yeast, liver, chocolate, processed foods, and MSG
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a manic depressive should be given what to supply adequate nutrition
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finger foods
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diet for chronic pancreatitis
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low fat bland
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Hep A pt should be on what type of percaution
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enteric
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Jaundice will be associated with
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liver disorders
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side effect of dilantin
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gum hyperplasia
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What should you watch for in Penylketonuria
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protein
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what happens in diabetic ketoacidosis
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fatty acids are broken down
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rapid insulins
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humalog
lispro novolog |
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rapid insulin onset and duration
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onset 5-10 min
duration 3-5 hrs peak 30-90 mins |
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short insulin
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regular
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short insulin onset and duration
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onset 30 min
duration 4-6 hrs peak 1-2 hrs |
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long lasting insulin
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Ultralente
lantus |
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Intermediate insulin
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NPH
lente |
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Intermediate insulin onset and duration
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onset 1-2 hrs
duration 8-24 hrs peak 4-6 hrs |
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what causes puritis with biliary cirrhosis of the liver
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retention of bile salts
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when should Acarbose be taken
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immedialtely before meals or with 1st bite of a meal-because it effects food absorption
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Why is lactulose given with cirrhosis
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to reduce ammonia
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if a pt is experiencing auditory hallucinations what is the most important nsg intervention
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determine what the voices are saying
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What is the primary focus of cognitive therapy
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current problems
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bipolar nsg dx
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risk for injury
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the most common inital finding during the onset of mania is
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rapid pressured speech
other findings: elated mood,increased activity, reduced sleep |
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What lab test should be performed and monitored at regular intervals for pt taking valproate acid
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liver functions
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lack of empathy is a behavioral characteristic of what disorder
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narcissistic personality disorder
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What is a priority for a family with a member who has schizophrenia
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reducing stress
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sublimination is
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transforming impulses into something constructive
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displacement is
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moving an impulse from one object to another
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rationalization is
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finding a rational explantion for questionable behaviors
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repression is
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banishing a memory -if the memory is banished the pain will not feel pain or sorrow
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fine hand tremors and slight thirst with lithum therapy would show a level of
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0.4-1.0
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Inability to sleep thru the night is a common symptom of
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post tramatic stress disorder
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vegetative signs of depression
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changes in bowel movements, eating habits, sleep disturbances, sex
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what should you watch for in a pt taking tricyclic antidepressants
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orthostatic hypotension due to alpha-adrenigic blockage
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an excess of what can exacerbate the symptoms of schizophrenia
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dopamine
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In conversion disorder there is an
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actual change or loss of body function
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what is used to treat severe hypoglycemia
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glugagon
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pt's recovering from pancreatitis should aviod
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caffine
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Signs of lithum toxicity
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acute confusion and ataxia
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lithium levels should be
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0.4-1.3
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how do you ck for patency of an atriovenous shunt in hemodialysis
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the presnce of Bruit
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In acute pancreatitis labs will show
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increase glucose and lipid
decreased calcium and potassium |
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early complaints of liver cirrhosis
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fatigue, bleeding gums, anoxeria, edema of the anides in the evening, epistaxis
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a sigh of transplant rejection is
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HTN
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if pt is wandering what can you do
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provide a braclet with pt info
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a child fails to grow above the 3rd percental in 2 years. What is the clinical manifestation
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Hypopituitarism
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what should pt do prior to paracentesis
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void
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What is the usual reaction of a woman dx'd with CA
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denial
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a husband had problems at work and comes home and hits wife what defense mechanism was used
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displacement
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korsakoff's syndrome is due to the deficiency of
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thiamine(B1)
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In order to prevent lipodysropy in diabetic pts you should
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rotate injection sites
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How can peripheral problems in diabetic pts be prevented
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examine skin daily for lesions
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a father lost his job and is very upset. What should be assessed first
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previous coping mechanism
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what should you ck for in a pt with esophageal varices
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portal HTN
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definitive diagnostic test for DM
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GTT
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DOC for manic depressive
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lithum
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What should be kept in pt room with esophageal balloon tamponade
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scissors at bedside to cut tip
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A pt has had their gallbladder removed. What are they at risk for
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atelectasis and dehiscence
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position of pt after liver biopsy
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R side with a pillow underneath
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1st priority for a batterd wife
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provide safety
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expected out come of kayexalate therapy
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decrease potassium
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what is a clinical sign of increased ammonia levels
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decreased consciousness
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DOC for acute pancreatitis
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demerol
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meds for N/V for cholecystitis
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compazine
meclazine tigan |
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a manic pt under milieu therapy has achieved goal if he
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gets along with staff
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Idiopathic nephrotic syndrome clinical manifestations
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double weight
protienuria albuminuria |
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myelomeningocele causes
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flaccid paralysis of the lower extremites
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What can you expect with hyperparathyroidism
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renal calculi
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pt in acute panic episode what should you do
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assure pt that the enviroment is safe
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what is the best way to deal with a depressed pt
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initate conversation
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you will find a low urine specific gravity in what disease
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diabetes inipidus
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a decrease in ESR indicates what in glomerulonephritis
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improvement
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a sign of a potential emotional problem in adolescent is he states
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I dont have any friends
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Haldol, an antisychotic drug has been given to a pt what side effect can you expect
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urinary frequency
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a pt is recieving clozaril which significant toxic risk must be assessed
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blood dyscrasia-monitor WBC count
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what state follows manic state
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depressed state
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why is atelectasis a complication after gallbladder surgery
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incision is close to the diaphragm and cause pain when the pt breaths
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What statement made by a pt indicates EPS meds are working
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my tongue doesnt feel thick anymore
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what is the cause of pancreatitis
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alcohol
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side effects of Haldol
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drowsiness, insomnia, weakness, HA,
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what lab gives most specific indication of kidney disese
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serum creatinine
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who would be an ideal donor
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sibling or twin
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after a bilateral adrenalectomy what will pt need take for life
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cortisone
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An alcoholic man states he drinks because no one understands how he works so hard -he is using what defense mechanism
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rationalization
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pyloric stenosis clincial manifestation
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epigastic nodule
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priority for pt with psychosis
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do not let them harm themselves or others
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pt with liver cirrhosis discharge instruction
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use soft bristle toothbrush
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To ck neurologic status of pt with hydrocephalus
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ask person, place, time
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NPH insulin is given to pt when will they experience low BS
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10 hrs
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What is used to block cravings for opiate based substances
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methadone
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What test is used for sudicial pt
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SADPERSONS
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mini mental staus examination measures
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orientation, recall, calculation and language
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cognitive assessment scale measures
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orientation, general knowledge, mental ability, and psychomotor function
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cognitive capacity screening measures
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orientation, memory, calcuation and language
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functional dementia scale measures
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orentation, affect, and the ability to perform ADL's
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CAGE questionare
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a 4 question tool in which 2-3 answers indicate alcoholism
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michigan alcoholism screeing test
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a 24 item timed test in which a score of 5 or better classifies an alcoholic
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beck depression inventory
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used to dx and determine the severity of depression
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minnesota multiphasic personality inventory assesses
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personality traits and ego function, including coping strategies, defences, gender ID, and self esteem
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A pt is preoccupied by fear of serious illness, interpreting all physical sensations as illness-impairs normal function, frequent visits to doctor despite ressurance all is well
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hypochondriasis
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treatment for hypochondriasis
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individual therapy
elavil, tofranil, nardil (tricylclic antidepressants and benzodiazepines) |
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Pt with major depression and anorexia and weight loss intervention
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stay with them during meals to encourage nutrition
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Pt with borderline personality disorder will be
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manipulative and impulsiveness
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pt with antisocial personality will have
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total disregard for others destructive and irritation in reponse to confrontation, lack of remorse arrogant
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What is Wernicke-Kofsakoff syndrome
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a dementing brain encephlopathy assoc. with chroinc alcoholism related to deficiency of thiamine(B1) due to malnutrition
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s/s of wernicke-kofaskoff syndrome
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fatigue, irritability,ptosis, anorexia, muscle tenderness
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what is clang association
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meaningless rhyming of words
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word salad
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a mixture of phrases meaningless to listener
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nealogisims are
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words made up by the person using them
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associative looseness is
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hapazard and confused thinking that is manifested in jumbles and illogical speech
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Normal tegretol levels
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6-8
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Haldol is used for
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hallucinations, delsions, disorderd thinking, paranoia
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low levels of what are associated with depression
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serotonin
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A decrease in what is associated with anxiety, schizophrenia and Huntingon chorea
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GABA
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What is a coexsiting conditon that a nurse should recognize as a problem with acute pancreatitis
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pleural effusion
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What is given to pt's with pancreatitis to aid in the digestion of fats, carbs and trigly.
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pancrease(pancrelipase)
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What provides the most information when diag. chronic pancreatitis
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ERCP
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progressive hepatic encelopathy will be characterized by
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a deteration of handwriting and the inablity to draw a simple star pattern
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What is a side effect of orinase
|
GI symptoms
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precose causes a decreased
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HA1C
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metaformin and glyburide cause a risk for
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hypoglycemia
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What will pt have with HHNS
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a BS of 750 or greater
elevated BUN and creatinine normal ph |
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Why is massage good for pt with impared liver function
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it promotes mobilization of edema
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A pt with diabetes insipidus will crave what
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cold water
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A pt with diabetes insipidus fluids should
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= output
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What is the key behavior in in antisocial persons
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aggression
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what is cirrhosis
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scaring of the liver resulting in impaired function and portal HTN
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Oral hypoglycemic drugs work by
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stimulating pancreatic cells to produce insulin
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Hepatic coma results primarily from accumulation of what substance in the blod
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ammonia
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a common cause of hypoparathyoidism is a
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thyroidectomy
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Diet of Nephrotic syndrome
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high protein
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a pt is undergoing a transphenoidal hypophysectomy this is the removal of
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the pituitary gland
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cushings syndrome results primarly from
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excessive secreations of adrenocortical hormones
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What EKG changes might be seen in renal failure
|
elevated T wave related to hyperkalemia
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|
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acromegaly
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is the result in excessive growth hormone seen in adults
|
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hypopituitarism in childhood
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sheehans syndrome-partial to complete loss of thyroid, adrenocortical, and gonadal function
|
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signs of thyroid toxicity
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rapid weight gain
extreme nervousness tachycardia HTN |
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Hashimotos Thyroiditis is
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hypothyroidism that is congenital or results from immunologic dysfunctions
|
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s/s of hypothyroidism/myxedema
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hair loss cold
brittle nails numbness/tingling enlarged tongue |
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s/s of Graves/hyperthyroidism
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insomnia
hot weakness muscle fatigue amenorrhea tachycardia goiter exophthlmos |
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how do antidepressants work
|
they inhibt reuptake of norepinephrine and serotoin
|
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what are the side effects of MAO INHIBITORS
|
orthostatic hypotension, dizziness, insominia,anoxeria
|
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Tardive Dyskinesia signs
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excessive blinking ,verm tongue movement, abnormal involuntary sucking, chewing licking, and pursing movements of the toungue and mouth
|
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bipolar disorder
|
severe mood disorder manifested by episodes of extreme sadness alternating with episodes of euphoria
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meds for bipolar
|
anticonvulsant, antimanic(lithum) and selective serotonin reuptake inhbitors(paxil)
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a lithum level of 2.2mEg/l will result in what
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ataxia
|
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interventions for cirrhosis
|
turn pt q 2 hrs
use soft toothbrush avoid im injections protect skin integrity |
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what is a major concern with liver dysfunction
|
bleeding
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what causes splenomegaly
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backup of blood from portal vein into the spleen
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What is given to a pt with diabetic ketoacidosis
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fast acting insulin
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pt's with HHNK need
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rehydration
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what is an indicator that Lithum therapy is working
|
concentration improves
|
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The DOC for manic depressive pt is
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lithum
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What hormone is deficient in diabetes insipidus
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ADH
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what do you expect when mother states her baby sleeps all the time and does not cry
|
cretinism
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pt's with renal calculi should increase fluid intake to
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2500cc/d
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The onset of alzheimers sx may be described as
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insidious
|
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An indication that lactulose has been effective is
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pt has increased alertness
|
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after a bilateral adrenalectomy what will pt need to take for lifetime
|
cortisone
|
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What effect will happen if you take thorazine with alcohol
|
quicker intoxication
|
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Why should steriod therapy be tapered
|
to prevent an addison's effect
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What is a clinical sign of esophageal varices
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hematemesis
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What is used to treat anemia in a pt with chronic renal failure
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epoietin alfa
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epoietin alfa increases
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the hematocrit
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What will happen if pt drinks alcohol while taking antabuse
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severe headache
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TRUST VS-MISTRUST
|
0-18 MONTHS
|
|
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AUTONOMOY VS SHAME AND DOUBT
|
18 MONTHS -3 YRS
|
|
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INITIATIVE VS GUILT
|
3-6YRS
|
|
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INDUSTRY VS INFERIORITY
|
6-12 YRS
|
|
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IDENTITY VS ROLE CONFUSION
|
12-20 YRS
|
|
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INTIMACY VS ISOLATION
|
20-25 YRS
|
|
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GENERATGIVITY VS STAGNATION
|
25-65 YEARS
|
|
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INTEGRITY VS DESPAIR
|
65-
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