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100 Cards in this Set
- Front
- Back
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Ringing in the ears
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Could be from:
salicylate intoxication pushing lasix too quickly -platin drugs (antineoplastic) -mycin drugs (aminoglycosides) |
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Dull ache
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could be a DVT
(Don't flex the knee; bedrest) or ectopic PG if in the abd |
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Cramping in the leg after a total knee replacement
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Could be a blood clot
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HYPOnatremia
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h/a, apprehension, lethargy, muscle twitching, convulsions, diarrhea, fingerprinting of skin
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Dye rxn
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edema, itching, wheezing, dyspnea
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Zinc Deficiency
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slow wound healing
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Iron Deficiency
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chronic fatigue
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s/s Addisonian crisis
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r/t decreased adrenals; precipitated by major stressor
sudden, PROFOUND weakness SEVERE abd, back and leg pain hyperpyrexia followed by hypothermia peripheral vascular collapse coma renal failure prevent by increasing dosage during times of stress *abrupt withdrawal of glucocorticoids can lead to this |
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s/s Thyroid storm
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increased temp (about 106)
SEVERE tachycardia flushing, sweating marked agitation and restlessness hyperreflexia abd pain, dehydration extreme vasodilation --> hypotension a-fib CV collapse delirium and coma can occur |
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s/s Anaphylactic Shock
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constriction of the airway (wheezing, dyspnea)
swelling of the throat/tongue skin rxns (hives, itching, flushed, pale) weak, thready pulse severe hypotension TX: EPI and O2! |
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s/s any kind of shock
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HYPOTENSION
cool, clammy skin cyanosis, restlessness, confusion weakness increased, weak thready pulse acidosis oliguria shallow, rapid respirations |
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s/s Septic Shock
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very high or very low temp
chills hypotension tachycardia SOB decreased LOC TX: abx, O2, fluids |
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s/s DIC
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clotting factors become abnormally active and eventually get used up
bleeding, bruising, drop in BP TX: underlying cause, replace clotting factor can be caused by infection/sepsis, burns, head injury, retained placenta |
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s/s spinal shock
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flaccid paralysis
complete loss of all sensation decreased pulses suppression of somatic and visceral reflexes |
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s/s Hemolytic Transfusion Rxn
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chills, fever, rash
flank/back pain bloody urine fainting/dizziness TX: stop transfusing, obtain a specimen, maintain fluids, antihistamine, steroids |
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s/s Hypertensive Crisis
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can be r/t interaction with MAOI's (like not following diet)
increased BP SEVERE H/A SEVERE anxiety SOB complications include: pulmonary edema, cerebral edema, stroke, MI, seizures, aortic dissection Tx: hold MAOI, do NOT let pt lie down, manage fever, meds that block norepi (nifidepine, phentolamine, chlorpromazine) |
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Severe Anxiety
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determine coping methods pt used in the past
priority is to find pt's inner strengths forget about "reflecting" |
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s/s myasthenic/cholineric crisis
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muscles that control breathing become too weak to do their jobs; from too much cholinesterase (-stigmine drugs)
bronchospasm with wheezing respiratory failure diaphoresis cyanosis SLUDGE Tx: mechanical breathing, blood-filtering therapies |
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s/s ANITcholinergic crisis
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too much anticholinergic drugs (for anti-parkinson's: cogentin, akineton; also TCA's)
"hot as a har, blind as a bat, mad as a hatter, and dry as a bone" fever hot dry skin, mouth widely dilated eyes, anxiety, delirium, hallucinations seizures increased HR Tx: stop offending med, give physostigmine, gastric lavage |
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SLUDGE
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salivation
lacrimation urinary incontinence diarrhea GI upset emesis |
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s/s Seratonin Syndrome
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when SSRI's are combined with MAOI's or TCA's
confusion autonomic dysfunction (increased HR, diaphoresis, "fight or flight"...) muscular rigidity ataxia |
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s/s Neuroleptic Malignant Syndrom (NMS)
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r/t starting or increasing antipsychotics, or surgical pts receiving anesthesia
hyperthermia muscular rigidity altered LOC Tx: FIRST stop med, fluids, cool down WITH COOLING BLANKET, give muscle relaxant or anticholinergic, call MD, document |
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s/s Lithium Toxicity
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check renal labs (excreted through kidneys)
severe diarrhea vomiting drowsiness muscle weakness/lack or coordination Tx: stop med, call MD, hemodialysis |
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Acute EPS
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from too much dopamine blocking meds
Acute Dystonia (torticollis, muscle spasms) - give cogentin/benedryl Akathesia (kathy can't stop moving) - reduce or stop med parkinsonism |
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Chronic EPS
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r/t long term use of phenothiazides (haldol, clozaril, prolixin...)
tardive dyskinesia - abnormal involuntary mvmts, lip smacking, grimace, tic |
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s/s dig toxicity
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N/V/D/A
Visual Changes (HALO, blurry, blind spots) confusion irregular HR, palpitations |
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s/s Cardiac Tamponade
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From fluid accumulating around the heart
Low/Narrowing BP JVD Muffled Heart sounds causes: CABG, hypothyroidism, trauma, MI... Tx: pericardiocentesis - place in semi-fowler's |
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s/s Autonomic Dysreflexia
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can be triggered by ANY noxious stimuli (full bladder/bowel, cool wind...)
very high blood pressure - the systolic may be greater than 300 bradycardia blurred vision throbbing headache sweating flushing erection of body hair nasal congestion increased spasticity nausea |
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s/s bladder perforation
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gross hematuria
suprapubic pain/tenderness inability or difficulty voiding |
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s/s lead poisoning
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Irritability
Loss of appetite Weight loss Sluggishness and fatigue Abdominal pain Vomiting Constipation Unusual paleness from anemia Learning difficulties Tx: goal is to get lead out of blood stream (milk/vit d optimizes disposition of lead into the long bones) |
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Cushing's triad
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late sign of increased ICP
widening pulse pressure decreased HR irregular respirations (cheyne-stokes) |
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cheyne-stokes
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apnea-tachypnea
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kussmaul's
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deep, rapid, labored respirations
(seen with acidosis) |
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A below than normal BUN may indicate...
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fluid overload
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If hemodialysis...
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limit potassium, sodium, phosphorus, and fluids
give hypotensive meds AFTER HD |
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If peritoneal dressing...
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clients are at risk for infection:
keep the dressing dry at all times change the dressing if it gets wet |
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AV shunt
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at risk for bleeding:
make SURE that small clamps are attached to the dressing (in case the shunt disconnects and the pt could lose blood very quickly) assess the site every 4 hrs |
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s/s aluminum toxicity
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used as phosphate binding agent during hemodialysis
mental cloudiness, dementia, bone pain (from infiltration of aluminum into the bone) tx with aluminum chelating agents |
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early s/s acute graft rejection
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will see within first 3 months (but can occur up to 2 yrs)
fever, HTN, malaise, graft tenderness tx: immediate steroids and abx |
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s/s peritonitis
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fever, nausea, malaise, rebound abd tenderness, cloudy dialysate
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complications of peritoneal dialysis and their symptoms
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bowel perforation (brown-tinged returns)
bladder perforation (yellow-tinged returns) infection (cloudy returns) bleeding (red or pink) |
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a pale stoma indicates...
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an inadequate amount of vascular supply
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a dark, dusky stoma indicates...
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a loss in vascular supply
REPORT IMMEDIATELY necrosis could occur |
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a dry stoma indicates...
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fluid deficit
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a red and moist stoma indicates...
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healthy!
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what are examples of oncological emergencies?
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superior vena cava syndrome
bone pain (indicates bone metastasis) hypercalcemia back pain (spinal cord compression) |
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ECG changes r/t hypercalcemia
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shortened ST segment
wide T wave |
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a common GI side effect of radiation is...
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diarrhea
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s/s lyme disease (stage 1)
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flu-like symptoms (HA, stiff neck, muscle aches, fatigue)
pimple-like bump that develops into ring-shaped rash Tx: oral abx rash |
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s/s lyme disease (stage 2)
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occurs several weeks after bite
joint pain neurological complications cardiac complications tx; iv abx |
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s/s lyme disease (stage 3)
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large joints become involved
arthritis progresses tx: iv abx |
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s/s AIDS
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flu-like symptoms
malaise fever anorexia, wt loss lymphadeopathy for atleast 3 months leukopenia diarrhea night sweats opportunistic infections protozoal, fungal, viral, bacterial infections neoplasms (kaposi/s sarcoma, non-hodgekin's lymphoma, cervical cancer) |
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what can indicate an MI?
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troponin I >1.5
troponin II >0.1-0.2 myoglobin >90 CK-MB >5% |
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s/s SLE
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butterfly rash (or upper body or palms)
photosensitivity fever wt loss malaise joint pain anemia (late) positive ANA test and lupus prep tx: steroids, comfort, avoid sun and hot baths, plasmapheresis |
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s/s scleroderma
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characterized by inflammation, fibrosis, and slerosis of connective tissue
pain stiffness and muscle weakness pitting edema of hands and fingers (progresses to rest of body) taut shiny skin free of wrinkles skin tissue that loses its elasticity and aderes to underlying structures dysphagia decreased ROM and joint contractures |
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silvery scales?
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psoriasis
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if allergic to these fruits, you are at risk for developing a latex allergy
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kiwis
bananas pineapples grapes tropical fruits avacados water chestnuts hazelnuts potatoes |
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what items are appropriate for a dressing change in someone who has a latex allergy?
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cotton pads and silk tape
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what is usually the first sign of pneumocystis jirovedi (toxoplasmosis)?
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cough
is a protozoan infection later signs: fever, dyspnea on exertion, and lastly dyspnea at rest |
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what is a mildly elevated sed rate?
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30-40
indicates milf inflammation |
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what is a moderately elevated sed rate?
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40-70
indicates moderate inflammation |
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what is a severely elevated sed rate?
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50-150
indicates severe inflammation |
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a serum amylase greater than 5 times the normal indicates...
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ACUTE pancreatitis
(normal is 25-151) |
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a serum amylase that does not exceed more than 3 times the normal indicates...
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CHRONIC pancreatitis
(normal is 25-151) |
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what are precipitating factors of SLE?
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meds
stress genetic factors SUNLIGHT or UV LIGHT pregnancy |
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total serum protein?
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6-8
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serum lipase levels?
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10-140
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a high serum lipase level may indicate...
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acute pancreatitis
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s/s ulcer perforation (surgical emergency)
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starts with a sudden, sharp, intolerable pain in the mid-epigastric area spreading over the abdomen
abdomen becomes rigid and board like N/V tachycardia as hypovolemic shock develops |
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should watch for elevated temp in a diabetic b/c...
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infection is the leading cause of HHNS or DKA
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s/s adrenal insufficiency
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hypotension
fever weakness mental status changes **look for these signs after an adrenalectomy |
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rebound tenderness may indicate...
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peritonitis (REPORT TO MD)
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if asterixes is present in cirrhosis...
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impending hepatic encephalopathy
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what type of ulcer's pain is relieved by eating food
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duodenal ulcer
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severe, RUQ pain that radiates to the right scapula and shoulder is indicative of what?
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acute cholecystitis
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what is the most common symptom of peritonitis?
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abd pain
(also tachycardia) |
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light or clay-colored stools is indicative of what?
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hepatitis (if conjugated bilirubin is unable to flow out of the liver)
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fainting could be an indication of what?
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cardiac dysrhythmia
needs cardiac evaluation |
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leukocytosis with "a shift to the left" refers to
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an increase in immature WBCs
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common signs of acute VIRAL hepatitis are...
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dark urine (excess bilirubin exreted by kidneys)
fatigue weight loss |
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s/s pernicious anemia
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**RISK FOR FALLS**
fatigue paresthesias impaired gait and balance |
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s/s ulcerative colitis
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diarrhea 10-20X/day with blood (therefore will have a low H&H)
wt loss, anorexia fatigue increased WBCs increased ESR dehydration, HYPOna/ka |
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the presence of a pulsation between the umbilicus and the pubis could indicate what?
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abdominal aortic aneurysm
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s/s mild phenytoin toxicity
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lateral nystagmus
loss of smooth EOM sedation |
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s/s severe phenytoin toxicity
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vertical nystagmus
diplopia ataxia, lurching gait coarse extremity tremor slurred speech altered LOC |
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a serum osmalality that signifies overhydration
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less than 285
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serum osmolality that signifies dehydration
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more than 295
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mild clumsiness is an initial sx of ...
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ALS (lou gerhig's)
(motor affected, not sensory) may complain of foot dragging or frequent tripping progressive muscle weakness until quadriplegia and eventually respiratory failure |
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what is the most critical index of CNS dysfunction?
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LOC
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hallmark signs of guillane barre?
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rapid onset of progressive muscle weakness
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intubate if lung vital capacity is less than...
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15
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excessive thirst + wt loss =
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probable type I DM
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low RBCs and Hct/Hgb
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decreased oxygenation of tissues (will see increased HR and RR)
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crackling under skin after removal of a chest tube indicates...
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subcutaneous emphysema which indicates pheumothorax
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what should you do if you auscultate a bruit (swooshing sound)?
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call the MD
indicates aortic aneurysm |
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pt complains of lower extremity weakness that is progressing upward, are you concerned?
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yes! emergency!
could indicate guillain-barre needs to go to ICU and watch for resp failure |
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s/s heat stroke
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temp > 105
hot, dry skin bizarre behavior confusion, delirium HYPOtension tachypnea, tachycardia |
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what is the most frequent cause of DIC?
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sepsis
look for blood at IV sites and around tubing |
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if a pt is showing signs of anaphylaxis (SOB, hives...), what is the FIRST thing you should do?
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ABC's!
establish the airway before it is lost...THEN administer epi |
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what is the first thing you should do if you notice signs of dilutional hyponatremia (especially if the pt is OCD)?
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SAFETY!
initiate seizure precautions THEN worry about giving IVF (HYPERtonic) |
