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41 Cards in this Set
- Front
- Back
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Name 3 reasons that cause diabetic ketoacidosis.
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pt. quits taking insulin
infection trauma |
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A pt. presents to your ER with confusion, combativeness, with a blood sugar of 697...what is your diagnosis?
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diabetic ketoacidosis
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What will you probably see on lab values of a pt with DKA?
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high sugar
K can be high. Normal or low will drop quickly when treating Ketoacidosis - pH low - serum CO2 low - Bicarbonate low because consumed by acid produced - B-hydroxybuterate elevated |
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When the pt's BS reaches ___it becomes a diuretic.
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250mg/dL
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What is the insulin/initial tx of DKA?
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LOTS of NS
insulin bolus 0.1mg/kg followed by a drip of 0.1mg/kg/hr |
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At what point do you add potassium to the DKA pt therapy?
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When the K+ level reaches 5.5 as insulin pushs K+ in to the cells
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At what point (what BS) do you need to add glucose to a DKA pt to avoid bottoming out the BS?
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when it reaches 250mg/dL
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What do you give the pt. if their pH begins to drop?
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bicarb
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What type of drug do you give a pt. if they have bone marrow depletion?
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erythropoietin
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Name 2 common meds you can prescribe for erythropoeitin.
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procrit
epogen |
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What does an injection of procrit do for a pt?
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stimulates red cell production and proliferation
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What 3 things (labs) should you check before giving someone erythropoeitin?
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-folate level
-Fe+ level -B 12 level Need these for absorption of the erythro. |
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What is the name of the long acting erythropoeitin?
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aranesp
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T/F
Erythropoeitin meds will help a pt's c/o fatigue. |
false
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What is the target hgb for someone receiving erythro?
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10-12
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What could happen if a pt's hbg is taken above 12?
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increased risk for thrombosis
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What drug is a granulocyte colony stimulator, WBC growth stimulator, used for neutropenia, for increased immune response to assist antibiotics?
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filgrastim (Neupogen)
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what drug is it...
- granulocyte/macrophage colony stimulating factor - after bone marrow transplant stimulates bone marrow at earlier stage than neupogen. - get macrophage and granulocyte reproduction |
sargramostim (Leukine, Prokine)
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What drug is it...
- long-acting granulocyte colony stimulating factor - has molecule that prevents breakdown by other factors |
pegfilgrastim (Neulasta)
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What drug is it...
- interleukin 11 (IL-11) - stimulates platelet production - strictly for platelet production - thrombocytopenia due to chemotherapy with bleeding is basically only indication. |
oprelvekin (Neumega)
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What is the body's first source of passive immunity?
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their mother
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what is active immunity?
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when your body develops its own immunity
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What types of immunglobulins are there?
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IgA IgD IgE IgG IgM
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What is the most common immunoglobulin that binds to foreign substances?
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IgG
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What immunoglobulin binds to histamines?
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IgE
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How often do you have to give immunoglobulins?
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not very often due to their long 1/2 life
18-32 days |
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What are Polygam and Gamimmune?
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IVIG-products of immunity
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where does IVIG come from?
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harvested during blood donation
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What type of problems can occur during immunoglobulin infusion?
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infusion reactions, infuse slowly
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Hyperab, Imogam Rabies are what type of immune globulins?
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rabies immune globulins
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rabies immune globulins are used for what types of immunity?
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passive immunity, post-exposure prophylaxis
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how is rabies immune globulin given?
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intramusculary
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What is Digibind used for?
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acute or chronic digoxin overdose WITH overdose
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Where does Digibind come from?
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sheep
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how is digoxin eliminated?
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kidneys
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_______ is tissue bound so needs to be released from tissue before all can be eliminated.
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digoxin
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what is a side effect of digoxin?
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hypokalemia-digoxin- cells that were blocked by digoxin are now free to uptake K causing a decrease in serum K.
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H-BIG, HyperHep are what type of immune globulin?
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hepatitis B
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hepatitis B immune globulin is used for...?
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passive immunity, post-exposure prophylaxis in non-immune patient
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RhoGAM is used for what?
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suppress antibody response of Rh- mother to Rh+ blood
for Rh- mother after first delivery of Rh+ infant |
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When is RhoGam given?
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subsequent pregnancies at 28 weeks and within 72 hours of delivery unless infant is Rh-
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