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87 Cards in this Set
- Front
- Back
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what are the dx findings of MS 2
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CSF- pressence of IgG antibody
MRI-MS plaques |
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what is the tx for MS
acute relapses iv/oral corticosteroids? 3 |
methleprenisolone floowed by oral prenisone taper;
azathiprine (imuran) cyclophophamide (cytoxan) |
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what is the tx for MS exacerbations? and who is it used on?
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interferon B (betaseron)
ambulatory pts; made w antiviral and immunoregulatory properties |
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what is the dx findgings of MG? 5
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tensilon (acetylcholinesterase inhibitor)
bld test-acet. recept antibodies present muscle stimulation test MRI-enlarged thymas EMG-delay of neuromuscular transmission |
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what is the tx for MG? cholinesterace inhibitor?
2 others? |
pyrostigmine bromide (mestinon)
-plasmapheresis -thymectomy |
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what are the dx findings of PK?
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hx and 2 of 4 sx..tremors, rigidity, bradykinesia, postural changes
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what is the tx for PK?
dopaminergics? 2 |
levodopa/carbidopa (sinment)
amatadine (symmetrel) |
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what is the tx for PK?
anticholinergic? 3 |
trihexphenidyl (artane)
beztropine (cogentine) ethoprpazine (parsidol) |
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what is the tx for PK?
dopamine agonists? 1 |
bromciptine (palodel)
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what is the tx for PK?
COMT inhibitors? 1 |
tolcapone
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what is the tx for PK?
MAOI 1 |
selegiline (deprenyl)
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what is the dx findings of ALS?
2 |
EMG and muslce biopsy
MRI-high signal intensity |
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what is the dx findings of Cor Pulmonale?
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CXR
ECG |
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what is the tx for Cor Pulmonale?
4 |
oxygen, bronchodilators, bronchial hygiene, diuretic therapy
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what is the dx findings for COPD?
4 |
PFT (inc residual vol and dec vital cap)
CXR ABG (reduced PAO2 normal or inc CO2) ECG-right heart |
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what is the tx for COPD?
6 |
oxygen
intubation aerosolized bronchodilators (albuterol, epi) corticosteroids diuretic antibiotic |
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what is the tx for GB?
7 |
ET
Prednisone (deltasone) Plasmaapheresis ECF Propranolol (indreal) dec tachy Atropine (brady) Volume rep to inc bp |
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what is the dx finding of ARDS?
6 |
-dec in pao2, resp alk, metabolic acid
-pa cath to id cause of edema -pawp is 12 lower in ards -suputm, blood cuture, serum amylase |
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what is the tx for ARDS?
8 |
oxygen
antibiotids/steroids diuretics vasosuppresors CPAP, ET PEEP suctioning |
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what is capoxone (glatiramer) used for?
precautions? route? adverse effects? |
used to tx ms and prevent relapse
-injection sites should be rotated so that no one spot is used more than once a week, keep refrigerated until use -subq daily -chest pain, muscle weakness |
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PH level
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7.35-7.45
low ac high alk |
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CO2 level
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35-45
low alk high ac |
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HCO3 level
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22-26
low ac high alk |
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PAO2 level
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80-100
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if SAO2 is below 95..what does that indicate?
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decreased saturation and may contribute to low PA02d
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what does r acidosis s/s look like?
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hypoventilation
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what does r alkilosis s/s look like?
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hyperventilation
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what are the s/s of hypoventilation? early 2
late 4 |
e: tachycardia,pnea
l:bradypnea,confusion, hypotension, lethargy |
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what are the s/s of hyperventilation? 6
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parasthesias, confusion, light headedness, anx, palpitations
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what are the s/s of metabolic ac? 7
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fruity breath, ha, lethargy, n.v, abd pain, tremors, confusion
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what are the s/s of metabolic alk? 7
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slow breathing, hypertonic muscles, twitching, confusion, tetany, seizures, dizziness
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what is novantrone (mitoxantrone) used for?
class? action? s/e? route? |
used for relapsing MS
-immune modifier -inhibits dna synethesis -cough, gi prob, alopecia, anemia, thrombocytopenia -iv every 3 mo |
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what is pleuritis?
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inflammation of the visceral and parietal pleurae that surround the lungs that line the thoracic cavity
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what is bronchitis?
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inflammation of the mucous membranes of the bronchial airways caused by irritation or infection or both by pathogen. can be acute or chronic
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what is consolidation?
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becoming solid, occurs during an infectious process such as pneumonia
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what is atelactasis?
3 things its casued by? |
collapse or airless condition of he alveoli caused by hypoventilation, obstruction to the airways, or compression
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what are the risk factors for sleep apnea?
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obesity
neck circumference high bp narrowed airway male old family hx alcohol, drugs, sedatives smoking sitting |
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what is a PE?
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obsturction of the pulmonary artery or one of its branches, caused by an embolus
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with a PE, blood flow abnormalities result in __/__ mismatch that is initially what?
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ventilation/perfusion
dead space ventilation |
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what is known as dead space ventilation?
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ventilation with no perfusion
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as atelactasis occurs what happens? what is it?
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shunting; perfusion without ventilation of the alveolus
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if the r side of the heart cant empty its volume against the increased pulmonary vascular resistance, what happens?
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r sided heart failure
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what is the tx for PE?
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thrombolytic, anticoagulant
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what are 5 adventitious breath sounds?
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crackles, wheeze, rhonchi, stridor, pleural friction
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what are crackles caused by?
when is it heard? |
collapsed or fluid filled alveoli popping open; inhale
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what are wheezes caused by?
when is it heard? |
narrowed airways, infection, heart failure, airway obstruction; exhale
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what are rhonchis caused by? when is it heard?
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fluid partially blocks the large airway; both inhale and exhale usually ex
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what are stridor sounds caused by? when is it heard?
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obstruction in the upper airway and requires immediate attention; inspiration usually w/o stethescope
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what are pleural friction rubs caused by? when is it heard?
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two layers of pleaura rubing together pt c/o pain where rub is heard; both in and ex
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what level of pa02 indicates severe hypoxia?
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85
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what is aminophyiline?
class? se? |
control of reversible airway obstruction caused by COPD and asthma
-bronchodilator/ methylxanthines -anx, tachycardia, n/v |
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what are the 3 reasons to percuss chest?
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boundaries; determine if filled with air, fluid, solid; eval distance the diaphragm travels b/t in and ex
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how to percuss the chest
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middle finger, tap
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what are the 2 warning sounds when percussing
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hyperresoonance, dullness
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what is hyperresonance?
3 indications? |
you have found area of increased air in lung or pleural space;
pneumothorax, acute asthma, emphysema |
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what is dullness?
3 indications? |
found areas of decreased air in lungs
pleural fluid, consolidation/atelactasis, tumor |
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what are the 7 s/s of pulmonary edema?
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increased r distress
dyspnea air hunger centeral cyanosis agitation/anx foamy/frothy secretions confusion |
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what are the 4 s/s of emphysesma?
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deff breathing
wloss chronic cough wheezing |
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sweat glands have a decreased activity in older clients so they need to do what?
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take care of skin, hydrate
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what is the normal pulmonary artery pressure?
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15-25 s
8-15 d a mean of 45 or higher may occur in cor pulmonale |
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MG is a disorder marked by fluctuating weakness in what two areas?
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oculofacial muscles and proximal limb
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after suctioning and before taking abgs the pt should have how long to recover?
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30 min
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what is a mantoux test?
when is it read? what are the mm? |
PPD containing 5 tb units administed idermally in the forearm and read 48-72 hr later. 10mm or more indicates pt has been exposed to tb 5mm in hiv
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with the mantoux test what does a pos reaction mean?
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does not mean that active disease is present but indicates exposure or presence of inactive disease. once pos will always be pos. cxr is necessary to r/o active tb
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what happens if the defense system of the body does not encapsulate the tubercle?
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bacteria may enter the lymph system and cause inflammatory response termed granulomatoud inflammation
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when primary lesions form, they can be reactivated and become what?
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secondary infection when reexposed to the bacterium
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in an active phase of tb, what can it cause? 2
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necrosis and cavitation in the leasions leading to rupture, spread of necrotic tissue and damage to various parts of the body; memonges, kidney, bones
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what is the most effective antitb med? dose? indications?
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isoniazide (INH) 5mg/kg/day up to 300mg po must be taken on empty stomach and w vit b
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how long do you need to be medicated w bacteriacidal for active tb; or exposure to active tb?
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6-12 mo
9-12 mo |
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what are the 3 other medications used for tb?
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rifadon, p namide, myonbutol??????
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what color do you see on xray with pulmonary edema?
vibration? percussion? auscultation? |
white lungs
normal resonant crackles, wheezes |
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what color do you see on an xray with bronchitis?
vibration? percussion? auscultation? |
white airway
normal resonant wheezes, rhonchi |
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what color do you see on an xray with pneumothorax?
vibration? percussion? auscultation? |
black
decreased hyperresonant (air) absent sounds |
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what color do you see on an xray with pneumonia/consolidation?
vibration? percussion? auscultation? |
white at infection
increased dull ronchi, crackles |
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when doing an egophyomy what is the sound and what does it mean?
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e sound clear a plueral effusion
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when doing a bronchophomy what is the sound and what does it mean?
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99 or 66 clear on lung base means consolidation
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what is a/c mode of ventilator
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full support, it pt makes effort, the a/c delivers its tidal volume
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what is simv mode of ventilator
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patial support, same as a/c but no tidal volume and no breath stacking
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what is cpap mode of ventilator
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no support, alarm sounds apnea ventilates when someone doesnt breath
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what is the early symptom of oxygen toxicity?
what are the other early signs? |
nonproductive cough
nasal congestion, sore throat |
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what are the s/s of ards?
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substernal discomfort or pain, gi upset, dyspnea, damage to lungs, pumonary edema and hemorrhage and stiffness of lung tissue can occur
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what are the lab tests used for hydration of elderly?
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urine specific gravity, urine color, bun creatinine ratio,serum sodium, serum osmolality
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s/s of hypokalemia?
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fatigue, weakness
anorexia, n/v dec bowel motility, ileus, abd distention paresthesias, leg cramp dec bp, ventricular asystole, fibrillation |
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s/s of hyperkalemia?
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tachy>>bradycardia
weakness, paralysis, paraesthesias colic, cramps, abd distention dysrrhythmias |
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s/s of hyponatremia?
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anorexia, n/v, confusion
ha, dizziness, lethargy cramps/weakness/twitching seuzures, papilledema inc pulse, dec bp weight gain, edema |
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s/s of hypernatremia?
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thirst, dry tongue/mucosa
hallucinations, irritability grand mal seizures pulm edema, hyperreflexia inc bp inc pulse |
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5 rights of delegation?
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task, circumstance, person, direction, supervision
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