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51 Cards in this Set

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  • Back

what is an EMG?

an electromyogram records/evaluates electrical activity of muscles during contraction; used to differentiate between muscle dysfunction and nerve dysfunction
they can be done IM (more common) or superficially
what teaching should be priority when a patient ingests a contrast medium?
increase fluid intake to promote elimination
initial stools may be white is barium was used, which is normal until all the medium is evacuated
what is an MRI and what is an important nursing consideration for them?
magnetic resonance imaging; uses magnetism, radio waves and a computer to get cross sectional images of body structures
**machine is loud and may exacerbate clostrophobia.
**a mild sedative may be given since stillness is important
**make sure NO METAL is present in room, in/on patient's body.
what is ANA?
antinuclear antibodies: seen in autoimmune diseases; these destroy the nucleus of cells.
present in RA, SLE, scleroderma etc.
what does the sed rate measure? (ESR)
measures the rate at which RBCs settle out of unclotted blood.
will be INCREASED with acute infections, inflammatory conditions, SLE, pregnancy, cancers, burns, RA and rheumatic fever
will be DECREASED with sickle cell anemia, degenerative arthritis, angina and factor V deficiency.
what is the importance of increased plasma uric acid?
diagnostic for gout; its the end product in metabolism of purines, and the kidneys normally secret it.
hyperuricemia occurs with poor kidney function, and or excessive purine intake
what is the purpose of traction?
to reduce fractures, lessen muscle spasms, relieve pain, correct deformities, promote rest and allow for exercise
skin and skeletal is most common- manual is only used briefly
what is countertraction?
pulling force exerted opposite of traction direction to patient from sliding
example includes elevating the foot of the bed so the patient is at an angle (trandelenburg)
what is important to teach a patient in traction about massaging or rubbing painful areas?
not to massage calves of reddened areas to prevent possible clot from dislodging
how can a nurse facilitate plaster cast drying?
turn the patient from side to side q2h for the first 24 to 72 hours
DONT use fingertips to turn, only palms- finger tips can create indentations in cast
what are important assessments for the nurse to make post laminectomy?
CMS checks and bowel and bladder function
complaints of severe headache, N/V, abdominal discomfort = CSF leak or CSF infection
some numbness and tingling is NORMAL and may persist for a little while
what is important to teach a patient with THR?
avoid adduction, and 90 degree flexion of the effected hip
-avoid sitting cross legged
-avoid twisting to reach for objects
-avoid tub baths for 4-6 weeks
- raise toilet seats and use sock pullers etc to avoid hyperflexion
-**physical therapy starts the next day post op!
what is medication therapy for osteoporosis?
-estrogen replacement therapy in post menapausal women is a PREVENTATIVE measure (pill or skin patch)
-calcitonin; hormone secreted by thyroid gland- it increases bone density
-aledronate prevents bone resorbtion; for men and women with steroid induced osteoporosis
-Evista; selective receptor modulator that prevents bone loss
how often should temp be assessed in osteomyletis?
what is an adverse effect of long term aminoglycoside use?
what is an adverse effect of long term cephalosporin use?
how is muscular dystrophy acquired?
sex linked genetic disorder
what is compartment syndrome?
impaired circulation caused by external pressure>30 mmHg (normal 10-20) that results in tissue death and nerve injury.
what causes compartment syndrome?
casts, splints, dressings, sickle cell crisis
what are the manifestations of compartment syndrome?
unrelieved, relentless pain, diminished or absent pulses distal to the injury, cyanosis of the extremity, parasthesia, loss of sensation, pallor, coolness, and weakness
when should you assess for a fat embolism and what are the S/S?
with musculoskeletal trauma!
s/s: chest pain, dyspnea, tachycardia, decreased O2 sats, changes in LOC, petichiae on upper trunk and axilla
what is a sprain?
a stretch or tear of a LIGAMENT
what is a strain?
a stretch or tear of a MUSCLE
what kind of drugs are used to treat gout?
anti-inflammatory agents like colchicines, NSAIDs, or corticosteroids
antihyperuricemics like alopurinol
and uricosurics like probenecid (increase exxcretion through urine)
fat emboli are more associated with what kind of injury?
a long bone fracture- particularly the head of the femur
what is the purpose of a chest tube?
to reestablish negative intrathoracic pressure following surgery, trauma, or pneumothorax and/or to provide drainage of blood, pleural effusion, or infected fluid (empyema)
things to remember about care of a patient with a chest tube:
-keep it below the level of the chest = gravity
-occlusive dressing around tube
-NEVER milk the tube unless ordered*
-NEVER clamp chest tube
-monitor output hourly
what is seen in the water seal chamber of a chest tube device?
few bubbles that fluctuate with breathing
barrel chest
difficulty exhaling
strongly associated with smoking
"pink puffer"
persistant tachycardia bc of inadequate O2
hyperinflated lungs and flattened diaphragm
increase fluid intake = liquify secretions
immunization against pneumonia q5 years
chronic bronchitis:
chronic airway inflammation
productive cough that lasts atleast 3 months
smoking main cause
inflammation= hyperplasia of mucus secreting glands= excessive sputum production
ineffective clearance- frequent infections
polycythemia develops to compensate to chronic hypoxia
"blue bloater"
drug therapy for COPD
bronchodilators are controversial- beta adrenergic agonist used in place (nebulizer or MDI)
anticholinergics (ipratropium/atrovent) = maintanance therapy by inhaler is MOST EFFECTIVE for COPD
long acting theophyline- controversial but strengthens diaphragm = decrease work of breathing
corticosteroids: controversial but good for pts with asthma or frequent exacerbations unresponsive to beta agonsits
viral pnuemonia
low grade fever
non productive cough
normal to small elevated WBC
less severe than bacterial
bacterial pnuemonia
high fever
productive cough
high WBC
obvious infiltrates in chest x ray
more severe than viral
acid fast bacillus (acid fast sputum test)
infection results from frequent close contact with infected person
immunity = granuloma lesion
part of this lesion = Ghon focus and material from here = passage of infectious particles to more airways WHERE THEY CAN BE EXHALED
characteristic frothy pink sputum
early symptom: nonproductive early morning cough
keep patient in private room with negative pressure
HCP wears N95 mask, patient wears normal face mask
INH for 12 months = drug of choice w/abnormal chest x ray or immunocompramized (HIV)
what part of the CNS controls cardiac function?
ANS: regulates cardiac function and BP
balance between sympathetic and parasympathetic branches
what role does the SNS have in cardiac function?
produces epinephrine and norepinephrine = increasing HR, myocardial contractility, and peripheral vasocontriction resulting in raised BP
what role does the PSNS have in cardiac function?
produces acetocholine = lowered HR and decreased contractility, opposite of sympathetic stimulation
what are early signs of digoxin toxicity?
N/V, anorexia, abdominal pain, bradycardia/dysrhythmias, and yellow/green visual halos
**hypokalemia increases the risk of Dig toxicity
how is sinus tachycardia treated?
treated only when patient is symptomatic or at risk for mycardial damage
treat underlying cause (hypovolemia, fever, pain etc)
beta blockers or verapamil may be used
how is sinus bradycardia treated
treated only when patient is symptomatic
IV atropine or pacemaker therapy may be used
**athletes may have sinus bradycardia without any decrease in CO (heart is stronger/more efficient)
how is PAC treated?
reduce alcohol, caffeine intake
reduce stress
stop smoking
what is left sided heart failure?
decreased ability of LV to pump blood into systemic circulation = decreased CO and back of blood into pulmonary circulation
-dyspnea on exertion (1st sign)
-new S3
-crackles, pulm edema
what is right sided heart failure?
RV has reduced capacity to pump blood into pulmonary circulation causing back up in venous circulation
-edema of lower extremities
-abdominal discomfort and nausea from liquid congestion in the abdominal organs
how do ACE inhibitors reduce BP?
inhibits the conversion of angiotensin1 to angiotensin 2 (a potent vasoconstrictor)
reduces peripheral resistance without changing CO
used in HTN, raynaud's syndrome, CHF
how do beta blockers reduce BP?
decreasing CO response to sympathetic nerve stimulation and renin secretion by the kidneys
reduces sympathetic vascular resisitance
used in

***avoid in patients with COPD
how do ARBs reduce BP?
blocks vasocontrictive effects of angiotensin 2
used in
-HTN alone or with LV hypertrophy, neuropathy, and T2DM
peripheral arterial disease:
patient experiances intermittent claudication
pain is relieved when extremity is in DEPENDANT position
what is Chron's disease aka regional enteritis?
chronic inflammation of the GI anywhere from mouth to anus but mostly occurring in iterminal illium
cause is unknown but probably autoimmune
lesions have "cobblestone appearance"
what assessment findings in chron's disease?
5-6 liquid stools a day, usually without blood
depending on location, stegorrhea may occur
abdominal pain in RLQ that is relieved by defecation
barium enema DX shows ulcerations, narrowing, strictures, and fistulas
what is the prescribed diet for Chron's disease?
high calorie, high protein. usually also need nutritional supplements
what should a patient with BPH avoid?
anticholinergics bc they cause urinary retention