Med Surg Quiz 1

Front 1

stress coping process

Back 1

short lived, quick.

compensatory process with physiological and psychological components

Front 2

day to day stress

Back 2

has greatest impact on health

Front 3

physiologic response to stress (what ns?)

Back 3

SNS (norepinephrine) is activated. cascade of neural and hormonal events.

Front 4

effects of stress

Back 4

peripheral vasoconstriction
bronchodilation
pupils dilate
dec GI activity
inc blood sugar/fatty acids
feeling of tension
inc sweating
inc rate of blood coag

Front 5

maladaptive stress

Back 5

drugs and alcohol
type a personality
denial
avoidance

Front 6

infant body fluid

Back 6

70-80%

Front 7

adults body fluid

Back 7

60%

Front 8

geriatric body fluid

Back 8

45-50%

Front 9

fluid loss sxs (4)

Back 9

mild lightheadedness
convulsions
coma
death

Front 10

intracellular (what ion? how much % body water?)

Back 10

2/3 of body fluid
K+ is prime cation

Front 11

what is extracellular fluid (3 things)

Back 11

intravascular and interstital
1/3 body fluid
Na+ prime cation

Front 12

input/outpt volume

Back 12

2600 mL/day

Front 13

inc volume
inc weight

Back 13

causes more fluid to leak out into intravascular area, into interstitial area

Front 14

hydrostatic pressure

Back 14

wt and volume
more volume IV causes inc BP
pushing pressure - water out of vessel

Front 15

osmotic pressure

Back 15

the pressure which needs to be applied to a solution to prevent the inward flow of water thru membrane

Front 16

osmolality

Back 16

# particles in kg of fluid (1L H2O)

Front 17

normal osmolarity of plasma

Back 17

250-375 mOsm/L

Front 18

Renin-Angiotensin-Aldosterone

Back 18

holds on to Na, H2O

Front 19

ADH

Back 19

holds onto urine

Front 20

Atrial Natiuretic Peptide

Back 20

inc absorption of Na/H20 (lose Na/H20 to urine)

activate when renal blood flow is low. SNS kicks in

Front 21

RAS system

Back 21

renin -> angiotensin 1 -> angiotensin 2 -> inc BP

renin -> secretion of aldosterone -> retain H2O and inc BV and BP

Front 22

hypervolemia/ FVE
caused by

Back 22

excessive IV infusions
replace water w/o Na
ADH secretion
Aldosterone (renal, adrenal, CHF, liver failure)
excess salt intake

Front 23

what FVE looks like

Back 23

fast wt gain
peripheral/periorbital edema
JVD, bounding HR, inc BP
inc CVP, RA pressure
SOB, crackles
dec Hct, Na (dilution)
headache, confusion

Front 24

normal CVP in RA

Back 24

6-12 cm H2O

Front 25

causes of edema

Back 25

inc capillary hydrostatic pressure
dec plasma protiens
obst lymphatics
kidney malfuction
inc capillary permeability
meds: steroids, NSAIDs, estrogen

Front 26

edema (2 types)

Back 26

generalized (anascarca)
localized

Front 27

1st space

Back 27

intravascular fluid

Front 28

2nd space

Back 28

interstital fluid (pitting edema)

Front 29

3rd space

Back 29

pericardium, pulmonary edema, etc

Front 30

intervention for FVE
(what position?)

Back 30

dec interstital fluid
promote circulation
skin integrity
semi-fowlers postition
i&o / weights

Front 31

FVD hypovolemia causes

Back 31

decreased intake
increased ouptput
decreased abs of fluid

Front 32

assessment for FVD

Back 32

dry mothe, sordes
dec skin turgor
inc temp
olig/anuria
inc hct, serum na, bun
restless
dec bp
dec cvp, flat veins

Front 33

interventions for FVD

Back 33

fluids
i&o /weights
skin integrity
hypovolemic shock

Front 34

na range

Back 34

135-145

Front 35

K range

Back 35

3.5-5.5

Front 36

chloride range

Back 36

96-106

Front 37

CO2

Back 37

24-30

Front 38

bun

Back 38

10-20

Front 39

creatinine

Back 39

0.7-1.5

Front 40

glucose

Back 40

80-110

Front 41

urine ph

Back 41

4.5-8.0

Front 42

urine spec gravity

Back 42

1.010-1.020

Front 43

hyponatremia sxs (6)

Back 43

AMS
headache
anorexia, N/v, cramps
muscel twitches

Front 44

hypernatremia sxs

Back 44

restelssness
AMS
twitching

Front 45

hypokalemia sxs

Back 45

slow reflexes
fatigue
constipation
lo T wave, U wave

Front 46

hyperkalemia sxs

Back 46

peaked t wave
nausea
irregular HR
acidosis

Front 47

hypokalemia sxs (4)

Back 47

slow reflexes, numbness
fatigue
constipation
lo T wave, U wave

Front 48

hyperkalemia sxs

Back 48

peaked t wave
nausea
irregular HR
acidosis

Front 49

hypotonic crystalloids

Back 49

.33, .45 NS
D5W

fluid out of vessels

Front 50

hypertonic crystalloids

Back 50

D5W .45NS
d5w .9 NS
3% NS
5% NS

fluid into vessels

Front 51

isotonic crystalloids

Back 51

0.9% NS
LR

too much too fast - FVE

Front 52

albumin 5, 25%

Back 52

keep fluid in vessels
good for shock tx

Front 53

dextran, hetastarch

Back 53

synthetic
fluid into vessels

Front 54

mannitol 5,25%

Back 54

fluid out of vessels
oliguric diuresis
eliminates cerebral edema

Front 55

hypercalemia sxs

Back 55

lethargy, wekaness
dec reflexes
constipation

Front 56

hypocalcemia sxs (6)

Back 56

muscle cramp, twitching
tetany - convulsions
cardiac arrythmias
trousseaus
chvosteks sign

Front 57

blood ph

Back 57

7.35-7.45

Front 58

pCO2

Back 58

35-45

Front 59

HCO3

Back 59

22-26

Front 60

resp acidosis cause

Back 60

depressed resp center
decreased lung surface

Front 61

resp alkalosis cause

Back 61

hyperventiliation

Front 62

METABOLIC acidosis cause

Back 62

DM
starvation
ASA overdose
renal failure
diarrhea
tissue anoxia (anerobic)

Front 63

metabolic alkalosis causes

Back 63

loss of HCL
excessive bicarbonate
fluid and electrolyte loss

Front 64

shock

Back 64

inatequate circulation to brain, heart, lo 02 delivered

Front 65

hypovoloemic shock cause

Back 65

loss in volume
trauma, surgery, burns, FVD

Front 66

cardiogenic shock

Back 66

pump failure
MI
arrythmias

Front 67

distributive shock

Back 67

pooling of blood - massive vasodilation
neurogenic - spinal injury
allergy
septic

Front 68

intervetions for shock

Back 68

ABC!
oxygen
fluids

Front 69

meds for shock

Back 69

sympathomimetic (dopamin, dobutamine)
vasodilators (nitroglyerine)

Front 70

diabetes insipidus

Back 70

low ADH

Front 71

cushings

Back 71

hi aldosterone

Front 72

addisons

Back 72

lo aldosterone

Front 73

parietal pleura

Back 73

lines thorax

Front 74

visceral pleura

Back 74

lines lungs

Front 75

what produces surfactant

Back 75

alveoli

Front 76

NIF

Back 76

negative inspiratory force

Front 77

ventilation

Back 77

move air in and out

Front 78

respiration

Back 78

gas exchange at cellular level

Front 79

inpiration

Back 79

diaphram contracts (down)
thoracic cavity expands
negative inspiratory force
active

Front 80

expiration

Back 80

diaphragm relax (up)
thorax decreases
positive force pushes air out
passive

Front 81

orthopnea

Back 81

pillows at night

Front 82

cyanosis

Back 82

late sign of hypoxia

Front 83

stridor

Back 83

high pitched sound
medical emergency
usually obstruction

Front 84

PEEP

Back 84

usually 5-10 cm
keep open alveoli
inc delivery of O2
lower conc of O2 needed

Front 85

pneumonia position

Back 85

sit up

Front 86

COPD

Back 86

slow progressive destruction of alveoli
loss of lung elasticity
CO2 retained (r. acid)
decreased gas exchange
expiration becomes active

emphysema
chronic bronchitis

Front 87

risk for COPD

Back 87

cigs
air pollution
AAT deficiency

Front 88

Sxs emphysema

Back 88

SOB, shallow
chest rigid
productive cough
long expiration
wheezes
clubbing
R side HF

Front 89

treat emphysema

Back 89

stop smoking
increase fluid
position, 02 therapy

Front 90

meds for emphysema

Back 90

broncodilator: antolin, atroven (B2)
corticosteriods: beclovent
aminophylline

Front 91

forced expiratory volume

Back 91

how fast air can be moved in and out

Front 92

forced vital capacity

Back 92

how much volume can be moved in and out

Front 93

sxs chronic bronchitis (4)

Back 93

excessive mucus
cough
dyspnea
lasting 3 mo+ in 2 consec yrs

Front 94

chronic bronchitis cause

Back 94

smoking
recurrent lower RT infections

Front 95

chronic bronchitis treat

Back 95

no smoking
treat LRT at first sign
increase fluid to liquefy

Front 96

asthma

Back 96

reversible
bronchoconstriction
swelling of mucus lining
thick secretion
no anatomical changes

Front 97

sxs asthma

Back 97

cough
wheezeing
dyspnea
anxiety
pale color
diaphoresis
tachy pulse
hypoxia, hypercapnea

Front 98

treat asthma

Back 98

avoid triggers
oxygen
breathing exercises
comfort

Front 99

asthma meds

Back 99

beta 2 agonisits
corticosteriods
mast cell stabilizers
methylxanthines
leukotrienes