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111 Cards in this Set
- Front
- Back
- 3rd side (hint)
Acute arterial occlusion s/s
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Poikilothermia (cool)
Pulselessness Paresthesia Paralysis Pale (pale mucous membranes also) Pain |
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Who gets chronic arterial occlusive disease earlier in their life?
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People with Diabetes
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Causes of thrombophelbitis
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venous stasis
damaged endothelium hypercoagulability |
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What is used to measure effectiveness of heparin?
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APPT
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What is used to measure effectiveness of coumadin?
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INR
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What is compatible with heparin IV?
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nothing
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Coumadin is influenced by what dietary element?
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Vitamin K
Many meds interfere with vit K |
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swelling (inflammation) of a vein caused by a
blood clot |
thrombophlebitis
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What are the 2 types of COPD?
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Chronic bronchitis
Emphysema (though most people with COPD have both conditions and possibly other conditions like asthma) |
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This is the presence of chronic productive cough for 3 months in each of 2 consecutive years in a patient in whom other causes of chronic cough have been excluded
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Chronic bronchitis
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This is the abnormal permanent enlargement of the air spaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis
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Emphysema
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COPD is the ___ leading cause of death in the US?
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4th
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What is the prognosis for people with COPD?
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1/2 of patients die within 10 years of diagnosis
(though this is complicated by the fact that most people are not diagnosed until the disease is advanced) |
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This causes:
SNS activation (increased HR, vasoconstriction, BP, and cardiac workload) decreased functional hemoglobin increased platelet aggregation |
nicotine
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What is the primary process of COPD?
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inflammation
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In COPD, what is the result of inflammation?
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production of more goblet cells (more mucus)
repeated damage and repair of lung tissue results in increased collagen and scar tissue formation (fibrosis) |
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Hypertrophy of the right side of the heart resulting from pulmonary hypertension
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cor pulmonale
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What test value determines the diagnosis of COPD?
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FEV1/FEV
(FEV1/FEV <70%) |
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Alveolar hypoxia and acidosis cause vasoconstriction, vascular remodeling, erythropoiesis. This increased viscosity of blood and decreased arterial diameter lead to what?
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Increased pulmonary vascular resistance
Cor pulmonale |
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Cor pulmonale affects what side of the heart?
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right
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s/s:
jugular venous distension hepatomegaly with rt upper quadrant tenderness ascites epigastric distress peripheral edema weight gain |
right-sided heart failure
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hypercarbia
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abnormally high level of carbon dioxide in the circulating blood
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sedatives, benzos, and opioids can do what to the COPD patient?
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a lack of drive to breathe leading to respiratory failure
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Why should COPD patients be monitored for occult blood in the stool and gastric aspirate?
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They have increased risk for duodenal ulcers that do not cause pain. This may be caused by increased gastric acid resulting from increased CO2 in patients who chronically retain CO2.
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What is the most effective intervention to stop the progression of COPD?
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stop smoking
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What do bronchodilators do for COPD patients?
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relaxes smooth muscle in the airway which improves the ventilation of the lungs and decreases SOB
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This drug's main benefit is to improve contractility of the diaphragm and decrease diaphragmatic fatigue
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long-acting theophylline
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These drugs for COPD help by decreasing inflammation. They are not helpful in mild cases, only with moderate-severe cases. They should not be used for long-term therapy.
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inhaled corticosteroids
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What should you have the patient do before obtaining a sputum specimen?
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rinse mouth with water
take several deep breaths, then cough |
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How many liters of oxygen should someone with COPD receive?
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1-2 liters/min
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What is a pneumothorax?
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air in the plural space, causing the lungs to collapse
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Assessment:
absent or diminished lung sounds hyperresonance use of accessory muscles for breathing prolonged expiration pulsus paradous (large decrease in systolic BP during inspiration) decreased air flow rates decrease oxygen saturation |
asthma
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Barrel chest is found in which condition?
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Emphysema
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Assessment:
cough exertional dyspnea sputum production use of accessory muscles for breathing prolonged expiration orthopnea respiratory acidosis decreased vital capacity |
COPD
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What is orthopnea?
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A condition in which there is difficulty in breathing except when sitting or standing upright.
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What intervention used for COPD or pneumonia will help with mucus buildup?
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Drink up to 3000 mL/day water
Administer mucolytics |
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What breath sounds might you hear with pneumonia?
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rhonchi and wheezes
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How long does it take for TB meds to greatly reduce the likelihood of transmission?
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2-3 weeks
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How is TB transmitted?
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droplets (laughing, coughing, singing)
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Assessment:
fatigue anorexia low-grade fever chills night sweats persistent productive cough occasional blood streaks in mucus |
TB
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When do most client's have a negative TB sputum test?
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after 3 months of treatment
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When can someone with TB usually go back to work?
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After 3 sputum tests have come back negative
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The accumulation and sequestration of trapped ECF in an actual or potential body space as a result of disease or injury.
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Third-spacing
can cause compartment syndrome |
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anasarca
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generalized edema, excessive accumulation of fluid in the interstitial spaces usually due to organ failure
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Why are infants and elderly at greater risk of fluid problems?
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Baby has higher % body water (80%)
normal adult is 60% elderly is only 55% |
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This IV fluid pulls fluid from the interstitial compartment into the vascular compartment.
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Colloids
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Used to increase vascular volume rapidly, such as in hemorrhage
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Colloids
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This IV fluid causes movement of water from cells into extracellular fluid
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Hypertonic:
Anything over 0.9% NS Most dextrose infusions |
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This IV fluid causes movement of water into cells
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Hypotonic:
Anything less than 0.9% NS |
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This IV fluid increases the extracellular fluid volume
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Isotonic:
0.9% NS D5W D5W 1/4 NS LR |
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About how much water is lost through the skin every day?
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400mL
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What is insensible water loss?
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Loss that the person doesn't know about, like through the skin and lungs
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What is the average amount of water lost through the lungs every day?
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350 mL
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Which IV solution should be given slowly?
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Hypotonic (to prevent edema)
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Assessment:
Polyuria Diarrhea Nonpitting edema Dysrhythmias Projectile vomitting |
Hypotonic overhydration (water intoxication)
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Normal sodium level
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135-145 mEq/L
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Assessment:
Rapid pulse Diminished deep tendon reflexes Hyperactive bowel sounds (increased motility) Polyuria Skeletal muscle weakness esp in extremities edema |
Hyponatremia
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What can you do for a pt with hyponatremia?
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restrict fluid intake
daily weight I/Os |
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Assessment:
twitches and irregular muscle contractions diminished deep tendon reflexes thirst dry mucous membranes decreased urinary output |
Hypernatremia
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Normal potassium level
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3.5 - 5.1 mEq/L
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Assessment:
weak irregular pulse muscle weakness leg cramps paresthesia decreased deep tendon reflexes nausea, vomitting, paralytic ileus polyuria |
Hypokalemia
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How fast can you administer potassium IV?
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less than 20 mEq/hr; prefer 5-10
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Assessment:
weak irregular pulse decreased BP muscle twitches paresthesia nausea, vomiting, diarrhea |
Hyperkalemia
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Normal calcium levels
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9 - 11 mg/dL (serum level)
OR 4.5 - 5.5 mEq/L |
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Assessment:
tingling of fingers numbness around mouth tetany, convulsions, muscle cramps Hyperactive deep tendon reflexes |
Hypocalcemia
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Chvostek's sign (Cheek)
and Trousseau's sign (T with fingers when using BP cuff) are signs of which electrolyte imbalance? |
Hypocalcemia
Hypomagnesemia |
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Assessment:
Increased BP profound muscle weakness diminished deep tendon reflexes decreased GI motility anorexia, nausea, constipation |
Hypercalcemia
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Normal magnesium level
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1.6 - 2.6 mg/dL
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Assessment:
rapid heart beat increased BP twitches paresthesia tetany, seizures hyperreflexia |
Hypomagnesemia
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Assessment:
bradycardia low BP diminished deep tendon reflexes skeletal muscle weakness |
Hypermagnesemia
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Vein inflammation associated with invasive procedures like IV placement.
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Phlebitis
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How do you treat phlebitis?
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apply warm moist packs
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Results from prolonged venous HTN, which stretches the veins and damages the valves
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venous insufficiency
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Venous or Arterial?
Brown discoloration along ankles |
Venous
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Venous or Arterial?
Ulcer - pink, uneven edges, granulation present |
Venous
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Venous or Arterial?
Intermittent claudication in buttocks or legs |
Arterial
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Venous or Arterial?
Gangrene |
Arterial
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Venous or Arterial?
Dependent rubor |
Arterial
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What is the classic symptom of PAD (peripheral artery disease)?
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Intermittent claudication
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ischemic muscle ache or pain that is precipitated by exercise and resolves within 10 minutes of rest
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Intermittent claudication
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Venous or Arterial?
Shiny, taut skin with hair loss |
Arterial
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Venous or Arterial?
Red, blue, or dusky when dependent |
Arterial
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Venous or Arterial?
Ulcers usually over bony prominences, on toes and feet |
Arterial
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Inflammation and thrombus obstruction of artery or vein, directly related to smoking
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Buerger's disease (thromboangitis obliterans)
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Episodic vasospasm of small cutaneous arteries of fingers and toes, associated with collagen diseases.
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Raynaud's phenomenon
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Three color changes - white, then blue, then red. Self-limiting, can be precipitated by cold, stress, caffeine, tobacco
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Raynaud's phenomenon
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How long do you receive anticoagulants after you have a DVT?
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3-6 months
Heparin bolus and then drip for up to 7 days |
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Phlegmasia cerulea dolens
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swollen, blue, painful leg
very rare complication DVT in someone with advanced cancer |
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What is the antidote for warfarin?
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Vitamin K
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INR:
normal and therapeutic level |
normal: 0.75 - 1.25
therapeutic: 2 - 3 |
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aPTT:
normal and therapeutic level |
normal: 24 - 36 seconds
therapeutic: 46 - 70 seconds |
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What is the antidote for heparin?
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protamine sulfate
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How can you relieve the pain/discomfort of varicose veins?
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walking or elevating limb
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Why does chronic venous insufficiency lead to brown leg color?
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RBCs leak out into tissue and then get broken down
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Venous or Arterial?
Thick, hardened skin |
Venous
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Venous or Arterial?
Increased temp in ankle area |
Venous
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Which nutrients are most important for healing?
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protein, Vitamin A and C, Zinc
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Venous or Arterial?
Skin thin, delicate, dry, shiny |
Arterial
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Venous or Arterial?
Temperature gradient down the leg |
Arterial
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Injury to the tendons and ligaments
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Sprain
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Excessive stretching of the muscle, often involving the tendon
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Strain
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Avulsion fracture
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severe strain in which the ligament pulls loose a fragment of bone
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Use RICE for most musculoskeletal injuries. What does RICE stand for?
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Rest
Ice Compression Elevation |
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When should you apply heat to a musculoskeletal injury?
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after 24 to 48 hours. Remember to leave heat on for a max of 20-30 minutes
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Subluxation
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partial dislocation
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CMS
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circulation
motion sensation |
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甘口
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/ sweet flavour/mildness/flattery/stupidity/
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[あまくち]
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Patients who have the best outcomes after a joint replacement have this characteristic
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self-efficacy
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What is the most common reason for knee arthroplasty?
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debilitating pain
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After total knee replacement, which type of exercise would you begin on the first day?
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isometric quadriceps setting
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Following knee surgery, put this on the knee when putting pressure on the joint.
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Knee immobilizer
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