NSG 170 lecture *FINAL EXAM
Increased susceptibility to infection (diabetes)
-Vascular; neurologic impairments; sensory impairments, slow healing -Nephrosclerosis; urinary retention; predisposed to pyelonephritis, urinary tract infection (UTI) -Progresses more rapidly if diabetes poorly controlled
Signs/symptoms of hyperthermia
-Vasodilation -Dry warm flushed skin/mucous membranes -Decreased urinary output -Profuse sweating -Seizures/delirium
Appearance of PAD ulcers
-Very little drainage -little tissue granulation (pale/very light pink OR necrotic/black) -Deep "punched out" w/ noticeable margins/edges that gives it a round appearance
Examination findings commonly associated with neoplasia
-Visible lesions -Physical asymmetry -Palpable masses -Unexplained bleeding (stool, urine, sputum) -Unexplained weight loss -Pain -Fatigue -Difficulty swallowing
Signs/symptoms of colon cancer
-Vomiting -Fatigue -Changes in bowel habits -Rectal bleeding -Anemia -Pain or cramping -Incomplete evacuation -Abdominal pain -Weight loss
Active internal (core) rewarming
-Warm IV fluids -Heated oxygen -Peritoneal, pleural, gastric, bladder lavage *warming from inside (core temp)
Peripheral venous disease (PVD) skin assessment
-Warm to touch -brownish color
This STD presents as single lesion or clusters that may be hard, yellow/gray on dry skin or may be pink/red/soft "cauliflower-like"
Condylomata Acuminata (genital warts)
This STI is caused by human papilloma virus (HPV)
Condylomata Acuminata (genital warts)
This is an inherited disorder that results in decreased cortisol, aldosterone production and increased androgen production
Congenital adrenal hyperplasia
Relatively ____ body core temperature
Constant *Core temperature can fluctuate in severe circumstances
Side effect of too much iron
Constipation
These medications end in "-sone/-ide"
Corticosteroids
Adrenal cortex secretes...
Corticosteroids: -Mineralocorticoids (aldosterone) -Glucocorticoids (cortisol, cortisone) -Gonadocorticoids (dehydroepiandrosterone (DHEA))
Targeted drugs (breast cancer) *action
Counteract specific genetic mutations that promote cancer growth
Congenital hypothyroidism can lead to...
Creatinism (severe physical and mental retardation)
Invasive core temperature measurement is only for...
Critically ill patients (esophageal probes, pulmonary artery probe, temp foley)
This STI can be transmitted to baby during delivery causing multi-system diseases
Genital herpes
This STI is diagnosed through viral culture or polymerase chain reaction assays (PCR) of the lesions
Genital herpes
This STI is not curable
Genital herpes
Dominant alleles express trait even if only one copy and recessive alleles can only express themselves if there are two copies (one from each parent) is an example of what?
Genotypes
Who is at a high risk for diabetic retinopathy?
Gestational diabetes (type 1)
How is hypopituitarism treated?
Give synthetic growth hormone
Sulfonylureas examples
Glipizide
Antihypoglycemic example
Glucagon
Symptoms of emphysema
-dyspnea (first sign) -insidious onset -minimal or absent cough -caloric demand increases w/ effort to breathe (weight loss) -adventitious lung sounds (diminished) -Barrel chest -Tripod position -pursed lip breathing -clubbed fingers -chest pain
Disorders associated with COPD are...
-emphysema -chronic bronchitis *can be either or both
Symptoms of aplastic anemia
-fatigue -pallor -weakness -exertional dyspnea -headache -tachycardia -heart failure
Acute transfusion reactions
-febrile -hemolytic -allergic -bacterial -circulatory overload -transfusion-associated graft versus host disease (TA-GVHD)
Chronic blood loss anemia
-fluid shifts from interstitial space to vessels -prevents hypovolemia -reduce blood viscosity may result in heart murmur -depletes iron stores -RBC's small, pale
Adverse reactions of magnesium sulfate
-flushing -sweating -hypotension -depressed DTR -CNS depression
Percussion
-forceful striking of skin with cupped hands, mechanical percussion cup, or vibrator -used to mechanically dislodge secretions from bronchial walls
Cardiovascular system includes
-heart -arteries -veins -capillaries
LMWH description
-heparin LIGHT -no high risk for bleeding
Crackles (adventitious breath sounds)
-high pitched popping sounds -inspiration sound associated with fluid -Associated with atelectasis (collapse of all or part of lung) -Obstruction (primary cause of atelectasis) -Non obstructive (pneumonia, pneumothorax, pleural effusion)
Stridor (adventitious breath sounds)·
-high pitched sound -in trachea & larynx -suggests narrowing of passage (croup and/or foreign body obstruction)
Wheezing (adventitious breath sounds)
-high pitched whistling -most often expiration, but inspiration too -narrowing of bronchi *wheezes don't disappear after coughing like rhonchi do
Erythropoietin side effects
-hypertension -thrombosis -headache
Sulfonylureas side effects
-hypoglycemia -weight gain
Symptoms of acute blood loss anemia
-hypotension -increased tachycardia -oliguria -decreased level of consciousness
If any adverse reactions occur during transfusion, the nurse should
-immediately stop the transfusion and begin normal saline -return all product and equipment to blood bank -notify physician
Treatment for COPD
-immunizations (pneumococcal, pneumonia, influenza, covid) -corticosteroid therapy -bronchodilators -broad spectrum antibiotic (if infection suspected) -statins (decrease cholesterol)
Medication for aplastic anemia
-immunosuppressives -prednisone -anti-thymocyte globulin -cyclosporine -daclizumab
Folic acid deficiency anemia
-inability to produce sufficient red blood cells due to the lack of folic acid -folic acid needed for maturation of RBCs -More common among undernourished people -Individuals with alcoholism at greater risk
Nutritional anemias
-iron deficiency -vitamin B12 deficiency -folic acid deficiency
Physiologic anemia of pregnant women
-iron deficiency anemia most common in pregnancy -gain in plasma volume (dilutes RBCs) -adverse outcomes for mother and fetus include increased risk for sepsis, maternal and perinatal mortality, low birth weight
Vitamin B12 deficiency anemia
-lack of intake of vitamin B12 -foods from animals' typical source of B12 -common in vegetarians/vegans, small bowel obstruction, chronic constipation
Home oxygen therapy via...
-liquid O2 -compressed gas cylinders -O2 concentrations
Bronchial sounds
-loud, high pitched -Heard over trachea -Longer on exhalation than inhalation
Pleural rub (adventitious breath sounds)
-low pitched crackling sound during both inspiration and expiration -Pleural inflammation causes surfaces to slide -Visceral (covers lung) -parietal (covers inside of chest wall)
Platelet transfusion are given for
-low platelet counts -active bleeding -scheduled for invasive procedure *only provides platelets
Bronchovesicular sounds
-medium loudness/pitch -heard on each side of the sternum between the scapulae -equal in duration during inhalation and exhalation
Many asthma drugs can be administered via...
-metered dose inhaler (MDI) -dry powder inhaler (DPI) -nebulizer
Treatment of tension pneumothorax
-needle decompression performed by physician -chest tube
Peak expiratory flow reading (PERF)
-objective assessment of lung function (green: 80-100% asthma is under control, yellow: 50-80% caution; need treatment, red: <50% immediate need for bronchodilator *further medical treatment is needed if level does not improve to yellow range immediately after use of bronchodilator
Symptoms of hypovolemia
-oliguria -tachypnea -tachycardia -hypotension
Red blood cells correlate with
-oxygen -carbon dioxide
Anemia occurs when...
-oxygen delivery is inadequate due to deficit volume of healthy RBC's (hematocrit) -reduced oxygen carrying capacity
Indications of compartment syndrome
-pain -swelling, taught skin
Symptoms of vitamin B12 deficiency anemia
-pallor -jaundice -weakness -glossitis -difficulty maintaining balance -paresthesia's -problems with proprioception *develops gradually *only B12 deficiency anemia that has neurologic symptoms
Symptoms of folic acid deficiency anemia
-pallor -progressive weakness and fatigue -shortness of breath -heart palpitations -glossitis (inflamed tongue) -cheilosis (cracked corners of mouth) -diarrhea *develops gradually *no neurologic symptoms
Common allergens causing asthma include
-pollens -weeds -dust mites -animal dander -exposure to aspirin (other NSAIDS) -stress -exercise -viral infection -exposure to hot/cold air -smoke & second hand
Symptoms of chronic bronchitis
-productive cough (large amounts of thick, tenacious sputum) -evidence of right-sided heart failure (distended neck veins) -adventitious lung sounds (rhonchi/wheezing)
The two semilunar valves are
-pulmonic -aortic
Rhythm is classified as
-regular (time between waves) -irregular (time between waves) *measure P to P or R to R
Lung sounds indicative of chronic bronchitis
-rhonchi -wheezing
Vibration (occurs AFTER percussion)
-series of vigorous quivering produced by hands flat on patient's chest wall -used after percussion to increase turbulence of exhaled air, loosening thick secretions
Risk factors for COPD
-smoking (greatest risk factor) -frequent exposure to smoke -long term exposure to chemical irritants (workplace or hobbies) -asthma may be risk factor -short term exposure to high levels of irritating substances (impaired lung function) -genetic (alpha1-antitrypsin deficiency)
Interventions for COPD
-smoking cessation (can improve lung function after COPD develops, prolonging survival) -avoid exposure to other airway irritants, allergens -remain indoors during periods of significant air pollution -exercise -hydration (fluid intake, humidifiers)
Symptoms of pernicious anemia
-smooth beefy red tongue -diarrhea
Complications of hemolytic anemia
-splenomegaly -jaundice -fractures -bone deformity
Symptoms of pneumothorax
-sudden sharp chest pain -shortness of breath -rapid & shallow breathing -fast heart rate -cyanosis -hypoxia -decreased/absent breath sounds -asymmetric chest rise
Medications for anemia
-supplemental iron (PO, IV, IM) -vitamin B12 supplements -folic acid supplements -immunosuppressive therapy in aplastic anemia based on autoimmune response (prednisone, anti-thymocyte globulin, cyclosporine, daclizumab)
Treatment of pneumothorax
-three-way dressing -chest tube -surgical repair
Symptoms of tension pneumothorax
-tracheal deviation -sudden sharp pleuritic pain (worsened by breathing) -decreased or absent breathing sounds over the affected side -asymmetrical chest wall movement -shortness of breath -cyanosis
The two AV valves are
-tricuspid (on right side of heart) -mitral/bicuspid (on left side of heart) *TRI (try) before you BI (buy)
Acute blood loss anemia
-triggers compensatory mechanisms -become less effective if hemorrhage continues, increasing risk for hypovolemic shock, circulatory failure -Circulating RBCs of normal size/shape
Symptoms of a severe episode of asthma
-use of accessory muscles for respirations -retractions -loud wheezing -distant breath sounds
Accurate/specific amounts of oxygen are available through...
-venturi mask -high flow nasal cannula *COPD patients
Dietary considerations for nutritional anemias
-vitamin C helps with absorption of iron -absorption is inhibited by tea and coffee *iron supplements (vitamins) side effects = constipation
Thiazolidinediones side effects
-weight gain -edema
Warfarin onset
-works SLOWLY -high risk bleeding
Example of hypotonic solution
0.45% & 0.33% sodium (lower osmolality) *pushes fluid into cells (increases intracellular)
Weight loss or gain of 1 kg (2.2 lbs) equals a loss/gain of ___ liters
1 liter
Alpha cells produce what?
Glucagon; stimulates breakdown of glycogen in liver, formation of carbohydrates in liver breakdown of lipids in both liver and adipose tissue *Increases blood sugar level
If both adrenal glands are removed, patients will require lifelong _____ and _____ replacement
Glucocorticoid and mineralocorticoid
Decreased uptake of glucose resulting in the breakdown of protein to amino acids for use as energy source
Gluconeogenesis
Drug treatment is IM ceftriaxone for what STI?
Gonorrhea
If patient tests positive for this infection, it is also recommended to treat the presumed co-infection of chlamydia with doxycycline
Gonorrhea
Watery/white discharge which may become purulent (yellow/green)
Gonorrhea
Which STI may cause sterility?
Gonorrhea
Organic erectile dysfunction
Gradual deterioration of function
Complication that can occur from BMT or SCT
Graft-versus-host disease (GVHD)
HELLP syndrome stands for
H(hemolysis) EL(elevated liver enzymes) LP(low platelet count)
Symptoms of hypertension
Headache, but usually no symptoms are present
These are chemical messengers secreted by various glands that exert controlling effects on cells of body. Purpose is to regulate metabolism, growth, reproduction, fluid and electrolyte balance, and gender differentiation
Hormones
Example of an autosomal dominant genetic disorder
Huntington's disease
High levels of calcium are defined as
Hypercalcemia
If PCO2 levels are elevated, it's called...
Hypercarbia (capnia)
High blood glucose is defined as
Hyperglycemia
Side effects of corticosteroids
Hyperglycemia
High potassium is defined as
Hyperkalemia
Should be concerned with ______ with blood transfusions
Hyperkalemia
Side effects of potassium sparing diuretics
Hyperkalemia
High levels of magnesium are defined as
Hypermagnesemia
High sodium is defined as
Hypernatremia
This is the emergent condition of type 2 diabetes
Hyperosmolar hyperglycemic syndrome (HHS)
Emergent (medical emergency) of hypertension is called...
Hypertensive crisis
Vasodilation occurs in
Hyperthermia
Graves' disease is another term for...
Hyperthyroidism
This dehydration occurs when there is a greater loss of water than sodium
Hypertonic (hypernatremic)
What kind of solution pulls fluid into vascular space (increases extracellular)?
Hypertonic *shrinks
The most common cause of respiratory alkalosis
Hyperventilation
Low levels of calcium are defined as
Hypocalcemia
If PCO2 levels are low, it's called...
Hypocarbia (capnia)
Low blood glucose is defined as
Hypoglycemia
Low potassium is defined as
Hypokalemia
Low levels of magnesium are defined as
Hypomagnesemia
Low sodium is defined as
Hyponatremia
What is considered the master switchboard of the endocrine system?
Hypothalamus
____ detects signals from the brain and circulating hormone levels; if the levels are too high or too low, the pituitary is triggered and there is an increase/decrease secretion of additional hormones
Hypothalamus
Vasoconstriction occurs in
Hypothermia
Hashimoto's disease is another term for...
Hypothyroidism
Patients who fail to be rewarmed may have...
Hypothyroidism
What kind of solution pushes fluid into cells (increases intracellular)?
Hypotonic *swells
This dehydration occurs when there is a greater loss of sodium than water
Hypotonic dehydration (hyponetremic)
Which contraceptives have the advantage of "copper ____ can also be used for emergency contraceptive"
IUD
Which contraceptives have the advantage of being effective for 5-10 years
IUD
Which contraceptives have the advantage of decreasing dysmenorrhea and menstrual blood loss?
IUD
Which contraceptives have the advantage of staying in place at all times
IUD
Which contraceptives have the disadvantage of may be expelled without the woman's knowledge?
IUD (must check for strings)
This type of rehydration is administered via electronic pump and is used when fluid deficit is severe or if the patient is unable to ingest fluids
IV fluids
Patients who have hypothyroidism (fail to be rewarmed) may require...
IV levothyroxine (and then restart warming initiatives)
What is the treatment for severe dehydration?
IV therapy with fluids and potentially electrolytes
Beta cells produce what?
Insulin; facilitates movement of glucose across cell membranes into cells, decreasing blood glucose levels *Decreases blood sugar level
Addition/intake of fluids and electrolytes to the body is called what?
Intake
Basophils action
Involved in allergic response
Braxton hicks' contractions
Irregular painless contractions (should be <5/hour)
What are the cells within the pancreas that produce hormones?
Islets of Langerhans
This is the most common kind of fluid volume deficit where fluid loss is not balanced by intake
Isotonic (isonatremic)
This imbalance occurs when water and electrolytes are lost or gained in equal proportions so that osmolality of body fluids remains constant
Isotonic imbalance
Moderate hypothermia signs/symptoms
-Depressed mental status -No shivering -Decreased respirations -Bradycardia -Irregular heartbeat -Hypotension -Pallor -Cyanosis -Hallucinations -Coma -Incoherence and periods of stupor
Treatment for hypoglycemia
-Determine glucose level -Determine level of consciousness
Chronic graft-versus-host disease (GVHD)
-Develops >3 months after transplant -May follow acute GVHD or may develop in patients with no previous symptoms -Chronic pain, fatigue, weakness, shortness of breath
Gestational hypertension
-Develops after 20 weeks of pregnancy -Not accompanied by proteinuria -May progress to preeclampsia -If persists more than 6 weeks after the birth, chronic hypertension is diagnosed
Acute graft-versus-host disease (GVHD)
-Develops within 3 months after transplant -Pruritic, maculopapular rash that begins in palms/feet, jaundice, nausea, vomiting, diarrhea, and dry eyes
Disorders of the pancreas
-Diabetes mellitus type 1 -Diabetes mellitus type 2 -Gestational diabetes
Which contraceptives have the disadvantage of added spermicide necessary for repeat coitus?
-Diaphragm -Cervical cap
Which contraceptives have the disadvantage of being initially expensive; requires healthcare provider to fit?
-Diaphragm -Cervical cap
Which contraceptives have the disadvantage of must remain in place at least 6 hours after coitus?
-Diaphragm -Cervical cap
Which contraceptives have the disadvantage of possible toxic shock syndrome or bladder infection?
-Diaphragm -Cervical cap
Inflammatory breast cancer (IBC)
-Diffuse erythema -Pain; rapidly growing breast lump; breast itching -Peau d'orange
Paget disease
-Disease of the nipple -Rarely occurs -Scaly, red, irritation
Radiation treatment (definition)
-Energy used to damage and kill cancer cells -"zapping local tissue/cells -Energy delivered to specifically targeted tissue area -Multiple forms of delivery -Multiple side effects require symptom management
Signs/symptoms of HHS
-Glucose >600 mg/dl -Increased urine output -Profound dehydration -Dry skin and mucous membranes -Extreme thirst -ALOC -Seizures -Lethargic
Pedigree (definition)
-Graph of family history for specific trait or health problem over several generations -Use at least three generations
Mucolytic examples
-Guaifenesin (oral) -Acetylcysteine (nebulizer)
Peripheral arterial disease (PAD) recognize these cues...
-Hair loss -Dry, scaly, pale, mottled skin -Thickened toenails
Side effects of all insulin types
-Hypoglycemia -hypokalemia -long-term use could potentially lead to renal or hepatic impairment, weight gain, immunogenicity
Causes of bradycardia
-Hypoglycemia -Hypothermia -Hypothyroidism -Cardiac history -Medications -Toxic exposure -MI
Side effects of thiazide diuretics
-Hypokalemia -Hypercalcemia
Side effects of loop diuretics
-Hypokalemia -Hypocalcemia
Menstrual cycle is regulated by hormone levels controlled by...
-Hypothalamus -Anterior pituitary -Ovaries
Which contraceptives have the disadvantage of potential side effects or complications
-IUD -Oral contraceptives
Treatment for status asthmaticus
-IV fluids -potent systemic bronchodilator -steroids -epinephrine -oxygen *potentially intubation
School age (sexuality)
-Identify with parent of same gender -Increased modesty -Advise parents to discuss basic information at about 10 years old
Assisted reproductive techniques (examples)
-In vitro fertilization (IVF) *IN the uterus -Gamete intrafallopian transfer (GIFT) *IN fallopian tube -Zygote intrafallopian transfer (ZIT) *IN fallopian tube -Intracytoplasmic sperm injection (ICSI)
Peripheral venous disease (PVD) (definition/causes)
-Inadequate venous return for a prolonged period of time -Prolonged standing/sitting -Thrombus formation -Defective valves
Biophysical profile
-Includes a nonstress test and transabdominal ultrasound -Analyses fetal breathing movement, gross fetal movement, fetal tone, amount of amniotic fluid -Done at 3rd trimester
Multiple Marker Screen
-Increased alpha fetal protein indicated neural tube defects -Decreased alpha fetal protein indicates down syndrome -Increased inhibin A indicates down syndrome -Increased HCG indicates down syndrome -16-18 weeks
Treatment for hypoparathyroidism
-Increased calcium in diet -IV calcium -Phosphorus binding drugs
Changes caused by placental hormones within the endocrine system
-Increased human chorionic gonadotropin (hCG) and estrogen levels may cause nausea in early pregnancy -Increased progesterone causes relaxation of smooth muscle, resulting in stasis of urine and constipation -Progesterone maintains the uterine lining, prevents contractions, and helps prepare breasts for lactation -Human chorionic somatomammotropin (hCS) increases availability of glucose for the fetus -Relaxin inhibits uterine activity and softens connective tissue in the cervix, and lengthens public ligaments
Treatment for hypertension
-Lifestyle changes -Diuretics (1st choice) -Beta blockers (choose selective beta blockers) (atenolol, bisoprolol, metoprolol) -Calcium channel blockers -ACE inhibitors -ARB's -Self management education
Prevention of STIs
-Limit number of sexual partners -Talk openly with sexual partners about safe sex and be honest about history -Abstain from high-risk sexual activity with unknown partner -Use condoms -Follow safe sex practices during oral sex -Report to health provider to exam when in doubt about exposure -Notify all partners of STI when diagnosed -HPV vaccination
Rh negative woman should receive Rh immunoglobulin when else? (Other than carrying/birthing an Rn positive baby)
-Miscarriage -Ectopic pregnancy -Induced abortion *To prevent the chance of the woman developing antibodies that could attack a future Rh-positive baby
Considerations for diuretics
-Monitor electrolytes -Orthostatic hypotension
· Considerations for Angiotensin converting enzyme inhibitors (ACEs)
-Monitor for crackles -Monitor for first dose -Monitor for edema -Monitor kidney function -AVOID in pregnancy -DO NOT abruptly stop (can cause rebound hypertension)
Considerations for direct vasodilators
-Monitor heart function -Orthostatic hypotension
Considerations for Angiotensin receptor blockers (ARBs)
-Monitor potassium/electrolytes -Increase fluids -Orthostatic hypotension -Renal function
Examples of Leukotriene modifiers
-Montelukast -Zafirlukast -Zileuton
Signs/symptoms of cushing syndrome
-Moon face -Buffalo hump -Central obesity
Essential hypertension (definition)
-Most common type of hypertension -Results in damage to vital organs -Causes medial hyperplasia (thickening) of arterioles
Considerations for Leukotriene modifiers
-NOT for acute asthma attacks -Use daily even with no symptoms
Causes of relative sodium excess
-NPO -Fever -Infection -Excessive sweating -Watery diarrhea -Diabetes insipidus
Common discomforts of pregnancy
-Nausea and vomiting -Heartburn -Backache -Round ligament pain -Urinary frequency -Varicosities -Constipation and hemorrhoids -Leg cramps
Hypoglycemia symptoms
-Nervousness -Irritability -Vision problems -Hunger -Diaphoresis -Anxiety -Palpitations -Neurological changes (impaired cerebral function) -Seizures -Unconsciousness -Death
Glucose challenge test (GCT)
-Nonfasting -Drink 50 grams of glucose (24-28 weeks) ->140 will be referred for GTT
Signs/symptoms of breast cancer
-Nontender lump in breast (most often upper outer quadrant) -Inflammation breast cancer (IBC): typically have pain or enlarged lump as well as erythema and edema -Abnormal nipple discharge -Rash around nipple area -Nipple retraction, dimpling of skin, or change in nipple position -May be nipple pain, scaliness, ulceration, skin irritation, discharge -May report burning or stinging sensation -Dense breast tissue increases risk *Many patients have no manifestations -Tumors may be present for 8-10 years before palpable -Mammography can detect tumor up to 2 years before palpable
Radiation therapy (colon cancer)
-Not primary treatment -Used preoperatively to shrink tumors -Palliative to control pain, hemorrhage, bowel obstruction, or metastasis to the lung *For rectal cancer (not colon) radiation is often a part of the treatment plan
Erectile dysfunction treatments
-Pharmacologic (oral-phosphodiesterase-5 inhibitors (PDE5) (result in smooth muscle relaxation and can lower blood pressure), penile injection, urethral suppositories) -Penile implant -Vacuum constriction devices
What anions make up intracellular fluid?
-Phosphate -Sulfate
Infant perfusion history assessment
-Poor feeding -Poor weight gain -Failure to thrive -Dusky color
What cations make up intracellular fluid?
-Potassium -Magnesium
Examples of corticosteroids
-Prednisone -Solumedrol -Budesonide -Fluticasone
The women scope is one of two states...
-Pregnant (unplanned, planned) -Unpregnant (by choice, not by choice)
Mechanism of action for LABAs
-Prevention of asthma attack -Relaxes smooth muscles in the airway -SLOW onset
SERMS: selective estrogen receptor modulators (tamoxifen citrate) *action
-Prevents estrogen from attaching to cancer cells which prevents growth -Used in early stage, advanced, and prevention for high risk
· Mechanism of action for Angiotensin receptor blockers (ARBs)
-Prevents the vasoconstrictor and aldosterone-secreting effects of angiotensin II by binding to the angiotensin II receptor sites -Suppresses RAAS -Lowers blood pressure -Lowers heart rate
Adolescence (sexuality)
-Primary and secondary sex characteristics develop (breast development, pubic hair, facial hair, etc.) -Menarche (often irregular to start, dysmenorrhea) -Develop relationships -Masturbation common -May be sexually active -May experiment with homosexuality -Risk for pregnancy -Risk for STIs -Parents influence values and beliefs regarding behavior
Signs/symptoms of heat stroke
-Profoundly elevated body temp 40°C (104°F) -Mental status changes (confusion, bizarre behavior, seizures, coma) -Hypotension -Tachycardia -Tachypnea -Elevated troponin level -Hot dry red skin -Electrolyte imbalance (sodium and potassium)
Acute peripheral arterial occlusion interventions
-Prompt treatment is important to prevent permanent damage or loss of extremity -Thrombectomy or embolectomy -Monitor for compartment syndrome
Nonsurgical treatment/management for colon cancer
-Radiation -Chemotherapy
Types of blood cells
-Red blood cells -Platelets -White blood cells
Manifestations of hypokalemia
-Reduced cellular excitability -Dysrhythmias (flat or inverted T waves) -Weakness -Orthostatic hypotension -Decreased DTR -Decreased bowel sounds
Manifestations of hypermagnesemia
-Reduced membrane excitability -Flaccid muscles/dec or absent DTRs -Drowsy/lethargic
What would induced hypothermia be used for?
-Reducing metabolic rate -Prevention of ischemia during surgery -Lowers cellular demand for oxygen in tissues (especially brain) -Reduce neurologic damage after head trauma or stroke and during cardiac surgery
Bone marrow transplant & stem cell transplantation
-Replaces diseased or destroyed cells from the bone marrow with normal healthy cells -Cells must be a close match (autologous (from patient) or allogeneic (from donor)) -Multiple complications can occur
Mechanism of action for SABAs
-Rescue med during asthma attack or just before activity/trigger -Relaxes smooth muscles in the airway
What would you monitor when giving magnesium sulfate?
-Respiratory rate -Blood pressure -Oxygen saturation -DTR -Urinary output -Signs of seizures (increase magnesium)
Pathophysiology of type 1 diabetes
-Results from destruction of beta cells of islets of Langerhans in the pancreas -Autoimmune destruction of islet beta cells
Hormone therapy (breast cancer)
-SERMS: selective estrogen receptor modulators (tamoxifen citrate) -Aromatase inhibitors (anastrozole, letrozole)
Heparin route
-SQ -IV
If rubella is contracted during pregnancy what happens?
It crosses placental barrier and can infect the fetus, which can be born with CRS (congenital rubella syndrome; results in hearing loss, cardiac defects, intellectual disability, microcephaly)
Which contraceptives have the disadvantage of requiring a high level of motivation and extensive education
Natural family planning
Which contraceptives have the disadvantage of requiring abstinence for a large part of each cycle
Natural family planning
Increased human chorionic gonadotropin (hCG) and estrogen levels may cause...
Nausea
Steadiness and variety in fetal heartrate during a contraction is a ____ CST
Negative, reassuring
Decreased neutrophils
Neutropenia
Fresh flowers or plants are usually not permitted for what?
Neutropenic children
Should not take erective dysfunction medications with ...?
Nitrates; nitroglycerine
Does HHS involve metabolic acidosis?
No
Is HHS ketotic?
No
Should a woman older than 35 and smokes use oral contraceptives?
No
Should women with any estrogen-dependent cancer or breast cancer use oral contraceptives?
No
Should women with benign or malignant liver tumors use oral contraceptives?
No
Should women with cerebrovascular or cardiovascular disease use oral contraceptives?
No
Should women with hypertension use oral contraceptives?
No
Should women with impaired liver function use oral contraceptives?
No
Should women with suspected or known pregnancy use oral contraceptives?
No
Should women with thrombophlebitis or thromboembolic disorders use oral contraceptives?
No
Should women with undiagnosed vaginal bleeding use oral contraceptives?
No
Would you do a rectal temp for a patient who has rectal hemorrhage?
No
Would you do a rectal temp for a patient who has rectal trauma?
No
Would you do a rectal temp for a patient who has risk for bleeding?
No
Would you do a rectal temp for infants?
No
Is a non-reactive stress test result reassuring?
No *(non-reassuring because you want reactivity)
Should individuals who have frequent hyperglycemia or hypoglycemia engage in prolonged exercise?
No, not until glucose control improves
A score of 4 or less on biophysical is ______
Non reassuring
Benign (definition)
Non-cancerous
Are solid foods measurable or non-measurable?
Non-measurable *occurs through perspiration
Is metabolism measurable or non-measurable?
Non-measurable *occurs through vaporization through the lungs
Due to the brown adipose tissue, newborns have...
Non-shivering thermogenesis
What helps infants to offset heat loss?
Non-shivering thermogenesis (increased metabolism and oxygen consumption)
Differentiation
Normal process occurring over many cell cycles that allows cells to specialize in certain tasks *cells in lungs vs cells in the brain
Example of isotonic solution
Normal saline (0.9% sodium) *no cellular shifts
If a diabetic patient is unable to eat for more than 24 hours and is vomiting/diarrhea lasts for more than 6 hours, what should they do?
Notify healthcare provider
Entire single chromosome added is indicative of what kind of chromosome abnormality?
Numerical
Entire single chromosome missing is indicative of what kind of chromosome abnormality?
Numerical
One or more added sets of chromosomes is indicative of what kind of chromosome abnormality?
Numerical
Chromosome abnormalities can be either ____ or ____
Numerical or structural
Signs and symptoms of ____ occur earlier with cancer in the ____ colon
Obstruction, descending
Onset of symptoms of chronic leukemia
Occurs over a period of months to years
Transverse (double-barreled) colostomy
Often used in such emergencies as intestinal obstruction or perforation because it can be created quickly. There are two stomas, The proximal one (closest to the small intestine) drains feces. The distal stoma drains mucus
Adrenal atrophy occurs in which age group?
Older adults
Decreased muscle mass occurs in which age group?
Older adults
Loss of elasticity, decreased turgor, and decreased reserves occurs in which age group?
Older adults
Reduced thirst reflex and decreased cognition occurs in which age group?
Older adults
Polyploidy
One or more added sets of chromosomes
Which contraceptive method is 99% effective when used correctly?
Oral contraceptives
Which contraceptives have the disadvantage of must be taken daily at or near the same time
Oral contraceptives
Which contraceptives have the disadvantage of must be taken within 120 hours of unprotected intercourse
Oral emergency contraception (plan B)
Treatment for Addison disease
Oral or injected corticosteroids
This type of rehydration is safest and most effective in alert patients. This must be done gradually (especially in older adults)
Oral rehydration
What is the first intervention for mild to moderate dehydration?
Oral rehydration
Vascular disease, endocrine disease, neurologic disease, chronic disease, penile disease or trauma, surgery, pharmaceutical therapy, and obesity can all cause of what type of erectile dysfunction?
Organic
This imbalance involves the loss or gain of only water so that the osmolality of the serum is altered
Osmolar imbalance
The movement of water only through a semipermeable membrane to achieve equilibrium of osmolality is defined as what?
Osmosis
Power of a solution to draw water across a semi-perm membrane is defined as what?
Osmotic pressure
The removal of fluids and electrolytes from the body in both normal and abnormal routes
Output
_____ produces and secretes female reproductive hormones (estrogen and progesterone)
Ovaries
Primary hyperparathyroidism is due to...
Overproduction by gland due to benign tumor of hyperplasia of gland
This hormone increases activation of vitamin D, controls phosphate and calcium metabolism
PTH
The cervix can turn a blue/purple color (Chadwick's sign) during what?
Pregnancy (due to increased blood flow and increased estrogen)
Doxycycline is contraindicated in which patient?
Pregnant
Eclampsia (definition)
Presence of a seizure in the preeclamptic woman *control external stimuli and initiate measures to protect the woman in case preeclampsia proceeds to eclamptic seizures
Side effect of nitroglycerine (sexuality)
Should not take erective dysfunction medications with nitrates
Oral phosphodiesterase 5 inhibitor example
Sildenafil (Viagra)
If only minor/short exposure to freezing temperature, then it might cause
Skin, subcutaneous tissue involvement
Chronic phase of chronic myeloid leukemia (CML)
Slow growing with mild manifestations that respond to therapy
Peripheral arterial disease (PAD) has a ______ onset
Slow/gradual
Mechanism of action (Oral phosphodiesterase 5 inhibitor)
Smooth muscle relaxation resulting in increased blood flow
Water flows where _____ goes!
Sodium
Antidote for aspirin
Sodium Bicarb
Delta cells produce what?
Somatostatin; neurotransmitter that inhibits production of both glucagon and insulin
A combination of hypoglycemia during the night with rebound morning rise in blood glucose to hyperglycemic levels is defined as?
Somogyi phenomenon
Malignant tumors acquire characteristics that allow them to...
Spread, invade, and destroy normal tissue
Increased progesterone causes relaxation of smooth muscle which results in...
Stasis (inactivity) of urine and constipation
Surgical intervention for aplastic anemia
Stem cell transplant
Which contraceptives have the advantage of "ends concern about contraception"
Sterilization
Which contraceptives have the advantage of tubal sterilization performed during or right after childbirth or between pregnancies?
Sterilization
Which contraceptives have the advantage of vasectomy performed in the physician's office with local anesthesia?
Sterilization
Which contraceptives have the disadvantage of difficult reversal, expensive, and can be unsuccessful?
Sterilization
Which contraceptives have the disadvantage of potential complications of any surgery?
Sterilization
Fragility of a specific site on the X chromosome is indicative of what kind of chromosome abnormality?
Structural
Part of a chromosome missing or added is indicative of what kind of chromosome abnormality?
Structural
Rearrangements of material within chromosome is indicative of what kind of chromosome abnormality?
Structural
Two chromosomes that adhere to each other is indicative of what kind of chromosome abnormality?
Structural
How would you calculate the estimated date of delivery?
Subtract 3 months from the first day of the last menstrual period, and then add 7 days *Adjust the year as necessary
Acute peripheral arterial occlusion has a ______ onset
Sudden/rapid
What does the adrenals control?
Sugar metabolism, kidney function, and stress
Numbness, itching, prickling is indicative of what?
Superficial frostbite (frostnip)
What is the disorder of the posterior pituitary?
Syndrome of inappropriate antidiuretic hormone (SIADH) *increased fluids
Treatment of hypothyroidism
Synthroid/levothroid (synthetic hormones)
If this STI is left untreated, the tertiary phase can lead to long term complications such as bone and liver tumors and cardiovascular issues
Syphilis
If this is untreated during pregnancy, it has been linked to miscarriage, premature birth, low birth weight, PROM, and chorioamnionitis
Syphilis
If untreated during pregnancy, this STI can cause stillbirth or neonatal death
Syphilis
Newborns infected with this STD may exhibit rhinitis, rash and hepatosplenomegaly. This can also affect teeth, bones, and hearing loss
Syphilis
This STD is diagnosed by blood tests (VDRL, RPR, or TURST)
Syphilis
Treatment for this STI is benzathine penicillin G
Syphilis
Which STD is Secondary phase is systemic and is manifested by skin eruptions, low grade fever, general malaise, and rash on feet/palms. This phase is highly contagious
Syphilis
Which STD is primary phase manifests as painless chancre, swollen lymph nodes. This stage is highly contagious
Syphilis
Body surface temperature will fluctuate FIRST (before core)? True or False?
TRUE
SERMS: selective estrogen receptor modulators *drug
Tamoxifen citrate
Fever of unknown origin (FUO)(definition)
Temp is >38.3°C (100.9°F) that lasts for >3 weeks
_____ produces and secretes male reproductive hormone (testosterone)
Testes
Heat balance
The amount of heat produced and lost are equal
The hypothalamus...
The body's internal thermostat (Balances heat loss and heat gain)
Chronic leukemia is a result of...
The breach of differentiation of the more mature cells (occurring at a later stage of cell development)
Pneumothorax occurs in...
The pleural space (the collapsed lung allows air to fill/enter the space)
Gas exchange
The process by which oxygen is transported to the cells and carbon dioxide is transported away from the cells
"Dub"/S2 is the sound of
The semilunar valves (pulmonic/aortic) closing
Body process that balances heat production and heat loss
Thermoregulation
If fluids and electrolytes are not absorbed, what happens?
They remain in the GI tract and leave the body in feces
Corneal edema causes what during pregnancy?
Thickening discomfort for women who wear contact lenses
Platelets examples
Thrombocytes
Decreased platelets
Thrombocytopenia
Increased platelets
Thrombocytosis
_____ produces T4, T3, TH, and calcitonin
Thyroid
Hyperplasia and increased vascularity in pregnancy cause _____ gland to enlarge
Thyroid gland
Stressors/infections can cause this emergent condition of hyperthyroidism
Thyroid storm
If you suspect an endocrine disorder, what diagnostic test would you prepare for?
Thyroid studies
Osmolality of a solution is defined as what?
Tonicity
Oligohydramnios (definition)
Too little amniotic fluid
Polyhydramnios (definition)
Too much amniotic fluid
What can cat litter lead to during pregnancy?
Toxoplasma
Born male but identify as female
Trans female/woman
Born female but identify as male
Trans male/man
Which contraceptive has an advantage of requires only weekly application?
Transdermal patch
Which contraceptives have an advantage of regulating menstrual cycles?
Transdermal patch
Which contraceptives have the disadvantage of "no protection against STDs"
Transdermal patch
Which contraceptives have the disadvantage of causing skin irritation
Transdermal patch
Which contraceptives have the disadvantage of having side effects similar to OC's
Transdermal patch
Which contraceptives have the disadvantage of may being less effective for women over 90kg (198 lb)
Transdermal patch
Which contraceptives have the disadvantage of must remembering to apply on the right day
Transdermal patch
Which contraceptives have the disadvantage of posing a higher risk for clot formation
Transdermal patch
Conduction (definition)
Transfer of heat from one molecule to a molecule of lower temperature (surfaces)
Radiation (definition)
Transfer of heat from surface of one object to surface of another (sun)
Someone who identifies with the opposite gender than their biological gender
Transgende
HER2 receptor agonist example
Trastuzumab (Herceptin)
Targeted drugs (breast cancer) *drug
Trastuzumab (Herceptin) *one of first targeted therapies for breast cancer *Targets HER2/neu gene product in breast cancer cells
Febrile seizures should be treated at first sign of increased temperature, True or false?
True
There is no definitive cause of fever of unknown origin (FUO), True or False?
True
Severity of hypothermia should not be based only on temperature. True or false?
True (consider the entire clinical presentation)
Autosomal recessive
Two copies of the mutation are needed to cause disease *bb
Individuals with this type of diabetes require lifelong exogenous insulin
Type 1
Insulin is no longer being produced in what type of diabetes?
Type 1
Is hypoglycemia more common in type 1 or type 2 diabetes?
Type 1
There are no prevention methods for this type of diabetes
Type 1
With this type of diabetes, the body does not produce enough insulin to keep the blood glucose levels within normal limits
Type 2
The treatment for this type of diabetes is oral glycemics or insulin therapy
Type 2 diabetes
Biologic therapy
Use of biological agents to activate the immune system as a cancer treatment
Rapid fire of QRS waves
V tach
Fluid inside blood vessels
Vascular
Reduced immunity in relation to diabetes (macrovascular)
Vascular changes and hyperglycemia reduce white blood cell activity inhibiting gas exchange and promoting growth of microorganisms
What type of medication is Angiotensin converting enzyme inhibitors (ACEs)?
Vasodilator
What type of medication is Angiotensin receptor blockers (ARBs)?
Vasodilator
Blast phase of chronic myeloid leukemia (CML)
Very aggressive leukemia with high percentage of blast cells and promyelocytes that spread to other organs
Gender identity
What gender an individual identifies with (male, female, nonbinary)
Fetal stage (definition)
When the embryo has human features and continues to develop/grow until birth
How is SIADH treated?
With vasopressin antagonists or diuretics to promote water loss
These medications end in "-phylline"
Xanthines
How often can you get FOBT
Yearly
Are LGBTQ+ population at an elevated risk for disability from chronic disease and mental distress?
Yes
Are endocrine disorders a risk factor for problems with thermoregulation?
Yes
Are environmental exposures a risk factor for problems with thermoregulation?
Yes
Are seizures a symptom of hypoglycemia?
Yes
Are tremors a symptom of hypoglycemia?
Yes
Can ACEs and ARBs cause hyperkalemia?
Yes
Can IV mag replacement cause hypermagnesemia?
Yes
Can NPO or too little potassium rich foods cause hypokalemia?
Yes
Can a viral illness trigger type 1 diabetes?
Yes
Can acidosis (DKA) or infection cause hyperkalemia?
Yes
Can blood transfusions of whole or packed cells cause hyperkalemia?
Yes
Can chronic alcohol use cause hypomagnesemia?
Yes
Can diarrhea, wound drainage, and immobility cause hypocalcemia?
Yes
Can diuretics or corticosteroids cause hypokalemia?
Yes
Can end stage renal disease cause hypocalcemia?
Yes
Can estrogen cause a sensation of blocked ears or temporary hearing loss during pregnancy?
Yes
Can excessive intake of calcium and/or vitamin D cause hypercalcemia?
Yes
Can excessive intake of magnesium (TUMS, laxatives) cause hypermagnesemia?
Yes
Can excessive potassium foods or medications or salt substitutes cause hyperkalemia?
Yes
Can h/o parathyroid gland removal or hypo function cause hypocalcemia?
Yes
Can heat stroke cause hypokalemia?
Yes
Can hyperemesis gravidarium cause a pregnant patient to be in a fluid volume deficit?
Yes
Can hyperparathyroidism cause hypercalcemia?
Yes
Can inadequate intake magnesium cause hypomagnesemia?
Yes
Can inadequate intake or inadequate vitamin D levels cause hypocalcemia?
Yes
Can increased secretion of aldosterone cause hypokalemia?
Yes
Can infants who are born to mothers with rubella during pregnancy be a risk to others when come in contact with them?
Yes
Can intake of alcohol and drugs cause hypoglycemia?
Yes
Can kidney disease (reducing excretion) cause hypermagnesemia?
Yes
Can kidney disease cause hypokalemia?
Yes
Can kidney failure cause hypercalcemia?
Yes
Can kidney failure/adrenal insufficiency cause hyperkalemia?
Yes
Can loop or thiazide diuretics cause hypomagnesemia?
Yes
Can malabsorption (celiac, chron's) cause hypomagnesemia?
Yes
Can malabsorption issues, such as celiac and crohn's cause hypocalcemia?
Yes
Can miscarriage cause a pregnant patient to be in a fluid volume deficit?
Yes
Can morning sickness cause a pregnant patient to be in a fluid volume deficit?
Yes
Can polyhydramnios's cause a pregnant patient to be in a fluid volume excess?
Yes
Can post-partum hemorrhage cause a pregnant patient to be in a fluid volume deficit?
Yes
Can potassium-sparing diuretics cause hyperkalemia?
Yes
Can preeclampsia cause a pregnant patient to be in a fluid volume excess?
Yes
Can pregnancy induced hypertension cause a fluid volume excess?
Yes
Can prolonged NG suctioning/would drainage cause hypokalemia?
Yes
Can rapid IV infusion with potassium solutions cause hyperkalemia?
Yes
Can thiazide diuretics cause hypercalcemia?
Yes
Can total parenteral nutrition cause hypokalemia?
Yes
Can vomiting/diarrhea cause hypokalemia?
Yes
Does medication cure the infection of gonorrhea?
Yes
Is altered level of consciousness a manifestation of DKA?
Yes
Is blurred vision a manifestation of DKA?
Yes
Is cognitive impairment a risk factor for problems with thermoregulation?
Yes
Is dehydration a symptom of hyperglycemia?
Yes
Is diaphoresis a symptom of hypoglycemia?
Yes
Is early menopause a risk factor for osteoporosis?
Yes
Is excessive caffeine a risk factor for osteoporosis?
Yes
Is excessive thirst a manifestation of DKA?
Yes
Is fatigue a symptom of hyperglycemia?
Yes
Is flushed, warm/dry skin a manifestation of DKA?
Yes
Is fruity odor to breath a symptom of hyperglycemia?
Yes
Is genetic predisposition a risk factor for problems with thermoregulation?
Yes
Is headache a symptom of hypoglycemia?
Yes
Is heart failure a risk factor for problems with thermoregulation?
Yes
Is hypermagnesemia rare?
Yes
Is inadequate calcium or vitamin D earlier in life a risk factor for osteoporosis?
Yes
Is irritability a symptom of hypoglycemia?
Yes
Is kussmaul breathing a symptom of hyperglycemia?
Yes
Is kussmaul respirations a manifestation of DKA?
Yes
Is late menarche a risk factor for osteoporosis?
Yes
Is malnourishment a risk factor for problems with thermoregulation?
Yes
Is polydipsia a symptom of hyperglycemia?
Yes
Is polyuria a symptom of hyperglycemia?
Yes
Is poor wound healing a symptom of hyperglycemia?
Yes
Is ptyalism (excessive salivation) normal in pregnancy?
Yes
Is reduced cognition a symptom of hypoglycemia?
Yes
Is smoking/ETOH use a risk factor for osteoporosis?
Yes
Is weakness a symptom of hypoglycemia?
Yes
Is weight loss a manifestation of DKA?
Yes
Is weight loss a symptom of hyperglycemia?
Yes
Should you have food at bedside for the patient when administering insulin?
Yes
Should you treat STDs during pregnancy?
Yes
Usually, can a pregnant woman who has had a baby before (multipara) feel fetal movements earlier than 16 weeks?
Yes
Would individuals continue to take their usual insulin dose or oral hypoglycemic agent per the "sick day" rules?
Yes
Would someone with diabetes might have to increase food intake before exercising?
Yes
Would you restrict fluids for a patient with fluid volume excess?
Yes
Would you use skin over sternum or on forehead instead of back of hand to assess skin turgor for older adults?
Yes
Should a patient be hospitalized if their glucose is <50 ml/dL?
Yes *Coma, seizures, altered behavior
Addison disease
Adrenal insufficiency
Hyperthyroidism results in...
-Too much TH -Increased energy
"Unrelated to coitus" is an advantage of what contraceptives?
-Transdermal patch -Hormone implant -Hormone injection -IUD -Oral contraceptives
Causes of pneumothorax
-Trauma (blunt, penetration, wounds) -Iatrogenic (transtracheal aspiration, lung biopsy, tube thoracotomy) -cough -cancer -chronic lung condition -pressure changes
Nursing care regarding anemia (leukemia)
-Treat anemia related fatigue due to reduced gas exchange and increased energy demands -Protect from injury related to bleeding due to poor clotting & chemotherapy -Bleeding: second most common cause of leukemia deaths -Instruct patient to avoid forceful blowing or picking of nose, forceful cough or sneezing, straining to have bowel movement -Monitor for abnormal blood levels of electrolytes uric acid, urea nitrogen, creatinine, or manifestations of Tumor Lysis syndrome -Assess vital signs every 4 hours and body systems every shift for bleeding -Avoid invasive procedures -Apply pressure to injection sites 3-5 minutes, to arterial punctures 15-20 minutes
Bone marrow transplant (BMT)
-Treatment of choice for some types -Often in conjunction with chemotherapy -Allogeneic BMT: bone marrow cells from donor with closely matched tissue antigens -Autologous BMT: patient's own bone marrow taken during period of remission
Chemotherapy (definition)
-Treatment with chemicals -Used to prevent cancer cells from multiplying, invading, or metastasizing (spreading) -Provides systemic treatment -Usually administered by nurses who are certified in providing chemotherapy -Multiple side effects require symptom management
Side effects of LABAs
-Tremors -Tachycardia -Anxiety
Side effects of SABAs
-Tremors -Tachycardia -Anxiety
Atherosclerosis (definition)
-Type of arteriosclerosis involving formation of plaque within arterial wall -Leading risk factor for cardiovascular disease
Examples of Anti-cholinergic
-Umedidinium -Tiotripium -Aclidinium -Ipratropium
Pathophysiology of leukemia
-Uncontrolled production of immature WBCs in the bone marrow -Classified by acuity (acute vs chronic) and predominant cell type (lymphocytic vs myeloid) involved
Side effects of NSAIDS
-Upset stomach -Bleeding -Ulcers
Complications involving the feet (diabetes)
-Vascular changes result in arteriosclerosis -Sense of touch and perception of pain are absent -Most common trauma (cracks, blisters, pressure, ingrown toenails) -Foot lesion begins as superficial skin ulcers, extends deeper, gangrene can develop -Refer to podiatrist for all foot and nail care *Do daily foot checks, don't go barefoot, no pedis, no heating pads
Heat stroke may cause...
-Vascular collapse -Cerebral edema -Central nervous system (CNS) dysfunction -Organ failure
What are the causes of organic erectile dysfunction?
-Vascular disease -Endocrine disease -Neurologic disease -Chronic disease -Penile disease or trauma -Surgery -Pharmaceutical therapy -Obesity
Components of the endometrial cycle
1.Proliferative phase 2.Secretory phase 3.Ischemic phase 4.Menstrual phase
What fraction of the body is extracellular fluid?
1/3
How often should you change a colostomy bag?
1/3-1/2 full
How many liters does interstitial space make up?
10-12 liters
Nonrebreather mask flow rate
10-15 L *not long-term use
Hyperglycemia range (fasting)
100
Prediabetic glucose range (fasting)
100-125
Normal glucose range (2 hour postprandial state)
100-140
An obese woman is expected to gain __-__ pounds during pregnancy
11-20 pounds
Normal fetal heartbeat
110-160 bpm *can be picked up by doppler at 9 weeks
Venturi mask flow rate
12-15 L
Normal hemoglobin range (female)
12-16 g/dL
Elevated BP range
120-129/80
Prehypertension BP range
120-139/80-89
Sodium (Na+) normal range
136-145 mEq/L (mmol/L)
Normal hemoglobin range (male)
14-18 g/dL
Protein intake should be __%-__% of daily diet
15%-20%
An overweight woman is expected to gain __-__ pounds during pregnancy
15-25 pounds
Platelets normal range
150,000-450,000
What is the time frame for triple/quad screening?
16-18 weeks of gestation
Umbilical cord has _ arteries ( _______ blood) and _ vein ( ______ blood)
2 (oxygenated), 1 (deoxygenated)
Left lung lobes
2 (upper & lower)
During which time period after contracting syphilis could the infection be transmitted to others?
2 years
Side effects of direct vasodilators
Affect perfusion to the brain (headaches)
Renin causes _____ to be released
Aldosterone
What happens during the embryonic stage?
All of the external and internal structures are developing *Therefore, toxins (alcohol, tobacco, radiation) must be avoided at this time
Foramen ovale function
Allows passage of blood from the right atrium to the left atrium; and then into the left ventricle
Alterations in VQ ratio could be...
Alveolus blocked by sputum, inflammation, atelectasis, fluid, FVE
If tissue becomes necrotic in frostbite, it may result in...
Amputation
Decreased RBCs
Anemia
These medications end in "-PRIL"
Angiotensin converting enzyme inhibitors (ACEs)
These medications end in "-SARTAN"
Angiotensin receptor blockers (ARBs)
Papanicolaou (pap) test is performed how often and at what age?
Annually after the age of 21
______ secretes TSH, FSH, and LH *growth, prolactin
Anterior pituitary
These medications end in "-ium"
Anti-cholinergic
What type of medication is Leukotriene modifiers?
Anti-inflammatory
What type of medication is corticosteroids?
Anti-inflammatory
Heat exhaustion/heat stroke is NOT treated with what?
Anti-pyretics
Decreased sexual desire and reduced response are side effects of which medication?
Anticonvulsants
Decreased sexual desire, orgasmic delay/dysfunction, delayed/failed ejaculation, painful erection are side effects of which medication?
Antidepressants
Which contraceptives have the disadvantage of added spermicide necessary for repeat coitus
Cervical cap
Which contraceptives have the disadvantage of requires education on proper use?
Cervical cap
Do insulin requirements change or stay the same throughout pregnancy?
Change, insulin requirements may double or quadruple by end of pregnancy
What could be an early sign of dehydration in older adults?
Changes in mental status
It is recommended that all women who are age 25 or less are screened for this STI annually (also women over 25 which multiple partners)
Chlamydia
Which STD is expedited partner therapy (EPT) recommended as part of treatment?
Chlamydia
Which STD is high risk for sterility due to bacteria spreading into fallopian tubes and uterus?
Chlamydia
Which STD is treated with azithromycin or doxycycline?
Chlamydia
Which STD may cause dysuria and urethritis?
Chlamydia
Which STD may have watery, mucoid discharge?
Chlamydia
Which infection is the most common cause of ophthalmia neonatorum in infants?
Chlamydia
Low levels of amniotic fluid may indicate that there's...
Chronic fetal hypoxia
Secondary hyperparathyroidism is due to...
Chronic kidney failure
Side effect of alcohol (sexuality)
Chronic use decreases desire
Peripheral venous disease (PVD) is also known as...
Chronic venous insufficiency
If PTT is too low
Clots will grow
Increased platelets (thrombocytosis) may result in what?
Clotting (MI, stroke, PE, DVT)
Encourage low fat and high fiber diets for what kind of cancer?
Colon
What is the definitive screening for colon cancer?
Colonoscopy
Total (simple) mastectomy
Complete removal of the breast tissue
In a frostbite patient, you want to avoid what?
Compression (compression syndrome)
Which contraceptives have the advantage of "can be carried discreetly"
Condoms
Which contraceptives have the advantage of "inexpensive per single use"
Condoms
Which contraceptives have the advantage of "no prescription needed"
Condoms
Which contraceptives have the advantage of "vaginal condoms increase women's control over contraceptive use and protection from STDs"
Condoms
Which contraceptives have the advantage of being quick and easy?
Condoms
Which contraceptives have the advantage of being the best protection available for STDs
Condoms
Which contraceptives have the disadvantage of can break or slip off
Condoms
Which contraceptives have the disadvantage of can only be used once
Condoms
Which contraceptives have the disadvantage of interfering with spontaneity
Condoms
Which contraceptives have the disadvantage of must be checked for expiration date and holes
Condoms
Certain strains of the causative agent are linked to cervical cancer
Condylomata Acuminata (genital warts)
Newborns of mothers infected with this STD may develop laryngeal papillomatosis
Condylomata Acuminata (genital warts)
One treatment for this STI is cryodestructive therapy
Condylomata Acuminata (genital warts)
One treatment for this STI is surgical excision
Condylomata Acuminata (genital warts)
Recurrence of this STI is likely
Condylomata Acuminata (genital warts)
Regular PAP tests can screen for the causative agent of this STI
Condylomata Acuminata (genital warts)
There is a vaccination to protect patients against the causative agent of this STD
Condylomata Acuminata (genital warts)
Patient with acute peripheral arterial occlusion will complain of...
Severe pain below the level of occlusion
Rewarming method depends on ___
Severity
Biological gender assigned at birth
Sex
A state of physical, emotional, mental, and social well-being in relation to sexuality
Sexual health
Who an individual is attracted to
Sexual orientation
All oral erectile dysfunction medications require ____ in order to work
Sexual stimulation (15mins-2hr onset depending on medication)
Atelectasis definition
collapsed lung; incomplete expansion of alveoli within the lung tissue
Venous system (definition)
completes circulation of blood by returning blood from capillaries to the right side of the heart
Use oxygen with caution in patients with chronic hypercarbia because...
concern about blunting hypoxic drive *use venturi mask for precise
CPAP
continuous positive airway pressure
Systole
contraction of the heart/ventricles
Determining ventricular rate
count the number of QRS (rate/6) or multiply by 10 to find rate/min
Mild hypothermia signs/symptoms
-Fatigue -Slurred speech -Poor coordination -Clumsiness -Confusion -Poor judgement -Shivering -Tachycardia -Tachypnea
Signs/symptoms of hypothyroidism
-Fatigue -Weight gain -Cold -Amenorrhea -Dry skin -Coarse hair -Constipation
Consequences of malignant neoplasia if treatment is unsuccessful
-Fatigue -Weight loss -Pain -Organ failure -Death
Disorders of the pituitary gland
-Hyperpituitarism -Syndrome of inappropriate antidiuretic hormone (SIADH) -Hypopituitarism
Antihypoglycemic side effects
-Hypertension -Tachycardia -Bronchospasm
Symptoms of preeclampsia
-Hypertension -Proteinuria -Hyperreflexia -Edema
Symptoms of HELLP
-Hypertension (may or may not have) -RUQ/low chest pain -RUQ tenderness -Nausea/vomiting -Severe edema -Severe headache -Vision problems
Disorders of the thyroid gland
-Hyperthyroidism -Hypothyroidism
At what age can a women switch to a mammogram every other year, or can choose to continue with yearly mammogram screenings?
55 and older
Partial rebreather flow rate
6-11 L
What is the target A1C during pregnancy?
6-6.5% (tends to be lower than normal because of increased RBC turnover
What is the goal for hemoglobin A1C?
6.5% or less
Normal sinus rhythm
60-100 bpm
Partial rebreather FIO2
60-75%
Infants have ___% total body water
65%
Febrile seizures are common in which age group?
6months - 5 years *peak in toddles
Normal ABG pH
7.35-7.45
Normal glucose range (fasting)
70-99
Newborns have ___% total body water
75%
What percentage of fluids make up the interstitial space?
75%
Normal ABG paO2
80-100 *note if patient was on supplemental oxygen
It is expected to see patients with COPD have a pulse oxygen of...
88-93% or <95%
Fetal stage occurs when?
9 weeks to birth
Calcium (Ca2+) normal range
9.0-10.5 mg/dL
Chloride (Cl-) normal range
98-106 mEq/L (mmol/L)
ABI of _____ indicates peripheral arterial disease (PAD)
<0.9
Normal BP range
<120/80
LDL normal range
<130
Triglyceride normal range
<150 mg/dL
Mild preeclampsia range
<160/100
Cholesterol intake should be ___ mg/day
<200
HDL normal range
<60
Sinus bradycardia
<60 bpm
Saturated fats intake should be ___ kcal/day
<7%
Hypoglycemia range
<70
Hyperglycemia range (2 hour postprandial state)
>140
Prediabetic glucose range (2 hour OGTT)
>140-200
Hypertensive crisis BP range
>180/120
An individual should test for ketones if blood glucose is greater than ___
>240 mg/dl
What is the glucose range for DKA?
>300 mg/dl
Nonrebreather FIO2
>90% *not long-term use
Which contraceptives have the advantage of preventing pregnancy after unprotected coitus?
Emergency contraception (plan B & copper IUD)
Which contraceptives have the disadvantage of being time sensitive?
Emergency contraception (plan B & copper IUD)
Which contraceptives have the disadvantage of may cause nausea?
Emergency contraception (plan B & copper IUD)
_____ (endocrine or exocrine) secretes directly into the blood stream
Endocrine
What does the thyroid control?
Energy, metabolism, and growth
Trisomy
Entire single chromosome added
Monosomy
Entire single chromosome missing
Body surface temperature rises and falls in response to...
Environmental factors
Chemical thermogenesis occurs as a result of...
Epinephrine release, which increases metabolic rate (production of heat)
Why are individuals who are obese have a higher risk for type 2 diabetes?
Excess body weight increases insulin resistance
Lumpectomy
Excision of primary tumor and some normal breast tissue
_____ (endocrine or exocrine) secretes through ductal system to epithelial surface (salivary, sweat)
Exocrine
Most common areas where frostbite occurs
Exposed or peripheral areas
Hypothermia frostbite (definition)
Exposure to extreme freezing temperatures for a substantial period of time
Is interstitial space apart of the extracellular space or intracellular space?
Extracellular
Is plasma volume apart of the extracellular space or intracellular space?
Extracellular
Holds fluid between the cells
Extracellular; interstitial fluid
Blood rewarmed outside body (hemodialysis) is used for...
Extreme hypothermia cases
Hyperpyrexia (definition)
Extremely high body temperature *medical emergency
Decreased capillary refill occurs in FVD or FVE?
FVD
Decreased pulse volume occurs in FVD or FVE?
FVD
Decreased urinary output occurs in FVD or FVE?
FVD
Decreased venous filling occurs in FVD or FVE?
FVD
Diminished skin turgor and dry pale skin occurs in FVD or FVE?
FVD
Fatigue occurs in FVD or FVE?
FVD
Flat neck veins occur in FVD or FVE?
FVD
Increased hematocrit occurs in FVD or FVE?
FVD
Increased urine specific gravity occurs in FVD or FVE?
FVD
Mucous membranes are going to be dry in FVD or FVE?
FVD
Orthostatic hypotension occurs in FVD or FVE?
FVD
Tachycardia occurs in FVD or FVE?
FVD
Thirst occurs in FVD or FVE?
FVD
Ascites, peripheral edema occurs in FVD or FVE?
FVE
Circulatory overload with heart failure symptoms occurs in FVD or FVE?
FVE
Cough, dyspnea, orthopnea, crackles occurs in FVD or FVE?
FVE
Decreased hematocrit and BUN occurs in FVD or FVE?
FVE
Distended neck, peripheral veins occurs in FVD or FVE?
FVE
Full bounding pulse occurs in FVD or FVE?
FVE
Increased central venous pressure occurs in FVD or FVE?
FVE
Polyuria occurs in FVD or FVE?
FVE
Weight gain >5% body weight occurs in FVD or FVE?
FVE
Treatment for compartment syndrome
Fasciotomy (relieves compartment pressure and prevent permanent neurologic damage)
Onset of symptoms of acute leukemia is...
Fast: occurs within a few weeks
-Headache -Elevated heart rate -Flushed -Warm to touch -Fatigue -Body aches -Dry skin/mucus membranes -Diaphoresis -Decreased urine output -Seizures (hyperpyrexia >41.5°C) are signs/symptoms of what?
Febrile
Develops through the fertilization of the ovum by an X barring sperm
Female fertilization
Set point in hypothalamus changes with what?
Fever (febrile, hyperpyrexia)
White blood cells action
Fights against infections
The movement of water through a cell or blood vessel membrane because of hydrostatic pressure differences on either side of the membrane is defined as what?
Filtration
ADH increases distal tubule permeability when there is FVD or FVE?
Fluid volume deficit
Decreased urine output (decreased serum/blood osmolality) occurs in FVD or FVE?
Fluid volume deficit
Increased reabsorption of H2O into blood occurs in FVD or FVE?
Fluid volume deficit
Osmolality (serum & urine), hematocrit, and specific gravity ALL INCREASE in what type of fluid imbalance?
Fluid volume deficit
Osmoreceptors in hypothalamus stimulate posterior pituitary to secrete ADH when there is a FVD or FVE?
Fluid volume deficit
ADH causes distal tubules to become less permeable to water when the body is experiencing FVD or FVE?
Fluid volume excess
Decreased reabsorption of H2O into blood occurs in FVD or FVE?
Fluid volume excess
Increased urine output (serum osmolality returns to normal) occurs in FVD or FVE?
Fluid volume excess
Is ADH suppressed in FVD or FVE?
Fluid volume excess
Osmolality (serum & urine), hematocrit, and specific gravity ALL DECREASE in what type of fluid imbalance?
Fluid volume excess
This occurs from too much fluid in the extracellular compartment
Fluid volume excess
This usually results from conditions causing retention of sodium and water
Fluid volume excess *high sodium foods, medications, IV fluids
Prevention of type 2 diabetes
Focus of care is on maintaining blood glucose at levels as nearly normal as possible through medications, dietary management, and exercise
Neural tube defects in pregnancy are in relation to which anemia?
Folic acid anemia
Biguanides side effects
GI upset (bloating, gas, diarrhea, loss of appetite,
Males attracted to males
Gay
Febrile seizures (definition)
Generalized seizure
If there's a family history of malignant hyperthermia, what diagnostic test would you prepare for?
Genetic testing
Phenotype (definition)
Genetic trait or characteristic that can be observed or determined by a laboratory test *Brown eyes, curly hair, red hair, blood type
Can cause preterm labor, spontaneous abortion, and stillbirth
Genital herpes
First outbreak of this STI is usually precipitated by flu-like symptoms (fever, general malaise, lymphadenopathy)
Genital herpes
Once primary lesions heal, this virus remains in a dormant state in the sacral nerve ganglia
Genital herpes
Outbreaks can be treated/suppressed with antiviral medications (such as Acyclovir)
Genital herpes
Periodically this virus activates, and symptoms recur. The recurrence can be triggered by stress, fever, sunburn, poor nutrition, menses, and sexual activity
Genital herpes
Primary involves presence of painful sores or large vesicles
Genital herpes
Recurrent occurrences are itchy/painful, may last up to 10 days, and patient may experience tingling, itching or pain before the outbreaks
Genital herpes
Which contraceptive has the disadvantage of side effects that are similar to other progestin contraceptives
Hormone injection
Which contraceptives have the advantage of not needing to use every day
Hormone injection
Which contraceptives have the advantage of requiring use only every 12 weeks?
Hormone injection
Which contraceptives have the disadvantage of causing a temporary decrease in bone density. Long-term effects unknown
Hormone injection
Which contraceptives have the disadvantage of having to remember to repeat every 12 weeks
Hormone injection
Long acting insulin examples
Insulin glargine
This type of insulin is rapid acting and has a <15 minute onset
Insulin lispro (Humalog)
Acanthosis nigricans
Marker of insulin resistance that appears in the folds of the skin, especially neck, thigh, axillae
Are enemas measurable or non-measurable fluids?
Measurable
Are irrigation fluids measurable or non-measurable fluids?
Measurable
Are oral fluids measurable or non-measurable?
Measurable
Are parenteral fluids measurable or non-measurable?
Measurable
How is hyperpituitarism treated?
Meds to block GH receptors or inhibit GH production or hypophysectomy
An increase in spaces in the bone (osteoporosis) occurs after...
Menopause
Therapy for menopause
Menopause hormone therapy (MHT)
Heat is a by-product of...
Metabolism
This is the process of biochemical reactions occurring in the body's cells that are necessary to produce energy, repair cells, and maintain life
Metabolism
Biguanides example
Metformin
What are long-term consequences of hyperglycemia?
Microvascular and macrovascular damage
Weight loss of 2-5% is ____ FVD
Mild
34-36°C (93.2-96.8°F) is indicative of what?
Mild hypothermia
Weight loss of 6-9% is ____ FVD
Moderate
30-34°C (86-93°F) is indicative of what?
Moderate hypothermia
Side effects of Xanthines
Monitor blood levels to ensure therapeutic range
Considerations for anticoagulants
Monitor for signs of bleeding/bruising
The parathyroid hormone (PTH) is released when ___ (more or less) calcium is needed in the blood
More
Hypothermia
More heat lost than produced
Hyperthermia
More heat produced than lost
Accelerated phase of chronic myeloid leukemia (CML)
More rapid growing with more severe manifestations, increased blast cells, and failure to respond to therapy
Side effects of Angiotensin receptor blockers (ARBs)
Muscle spasms
Prolonged hyperkalemia can cause what?
Muscle weakness to flaccid paralysis
Myeloid leukemia (cell type)
Myeloid stem cells interfering with maturation of all blood cells granulocytes, RBCs, and thrombocytes
Troponin test indicates
Myocardia infarction (MI) damage
Intermediate insulin examples
NPH insulin
This type of insulin is intermediate or long acting and becomes cloudy when mixed
NPH insulin
Inhibited sexual desire and response and erectile and ejaculatory dysfunctions are side effects of which medication?
Narcotics
Which contraceptives have the advantage of being able to be combined with barrier methods to increase the effectiveness
Natural family planning
Which contraceptives have the advantage of being acceptable to most religions
Natural family planning
Which contraceptives have the advantage of being inexpensive?
Natural family planning
Which contraceptives have the advantage of helping a woman learn about her body
Natural family planning
Which contraceptives have the advantage of may be used to help achieve pregnancy
Natural family planning
Which contraceptives have the advantage of no drugs or hormones?
Natural family planning
Physiologic menopausal changes
-Breasts become smaller -Uterus and ovaries atrophy -Decreased bladder and urethral tone -LDL increases -HDL decreases -Hot flashes/flushes
Side effect of antihistamines (sexuality)
-Decreased vaginal lubrication -Decreased desire
Side effect of diuretics (sexuality)
-Decreased vaginal lubrication -Decreased desire -Erectile dysfunction
Mechanism of action for Calcium channel blockers
-Decreases blood pressure -Decreases heart rate
Mechanism of action for diuretics
-Decreases water and sodium -Decreases edema
Which contraceptives have the disadvantage of "many factors may change ovulation time"
Natural family planning
Which contraceptives have the disadvantage of high risk of pregnancy from error
Natural family planning
Induced hypothermia is not recommended during what?
Pregnancy
Alcohol is a peripheral vasodilator; both alcohol and caffeine are diuretics... These effects can potentially worsen what?
-Dehydration -Hypothermia
Location of PAD lesions
-End of toes -Top of feet (dorsum) -Lateral ankle region (malleolus)
Considerations for anemia
(-monitor lips and tongue for glossitis and cheilosis -use (non-alcohol based) mouthwash every 2-4 hours -provide frequent oral hygiene -apply (petroleum babes) lubricating jelly or ointment to lips -encourage soft, cool, bland foods -encourage patients to eat 4-6 small high-protein, high vitamin meals per day)
Normal temperature for an infant
(97-99°F)
Aromatase inhibitors *drugs
-Anastrozole -Letrozole
3 BIGGEST concerns with leukemia
-Anemia -Infection -Bleeding
Most common sites of metastasis (spreading) from breast cancer
-Brain -Bones -Liver -Lungs
What are the least reliable methods of contraception?
-Breastfeeding -Coitus interruptus ("pull out" method)
Heat stroke
*(can be exertional or non-exertional) profoundly elevated body temp, but can occur at lower temps too -Mental status changes (confusion, bizarre behavior, seizures, coma) -Hypotension -Tachycardia -Tachypnea -Elevated troponin level (stress on heart) *Can lead to death (acute and emergent)
Radiation side effects
*Acute and long term -Nausea/vomiting -Radiation dermatitis (changes in skin) -Permanent hair loss (radiation to the head) -Altered taste -Fatigue (due to increased energy demand) -Bone marrow suppression -Reduced immunity -Inflammation (tissue fibrosis, scarring)
Stage 1 peripheral arterial disease (PAD) assessment
*Asymptomatic -No claudication is present -Bruit or aneurysm may be present -Pedal pulses are decreased or absent
Stage 2 peripheral arterial disease (PAD) assessment
*Claudication -Muscle pain/burning with exercise -Pain relieved with rest
Treatment for hypokalemia
*Determine cause -Give potassium **HIGH ALERT DRUG; NEVER IV push, IM or SQ. PO or IV infusion SLOWLY
Treatments for hypomagnesemia
*Determine cause -Increase magnesium intake -Magnesium sulfate IV (IF SEVERE)
Treatment for hyponatremia
*Determine cause -Increase sodium foods (if mild) -Give sodium fluids -Diuretics (if dilutional)
Treatment for hypercalcemia
*Determine cause -Reduce/remove vitamin D supplements -Low calcium diet -Parathyroidectomy -NS fluids which cause calcium excretion by kidneys -Consider d/c or change drug causing/calcium binders
Treatment for hypocalcemia
*Determine cause -Replacement depending on severity (PO/IV) -Increase calcium rich foods/Ca or vitamin D supplements -Reduce stimuli (seizures)
Treatment for hyperkalemia
*Determine cause -Restrict potassium intake -Calcium gluconate (protects heart) -Insulin and glucose simultaneously -Patiromer or sodium polystyrene sulfonate (kayexalate)
Treatment for hypernatremia
*Determine cause -Slow fluid replacement -Restrict fluid and salt intake -Diuretics
Signs/symptoms of Addison disease
*Develop slowly over several months -Fatigue -Joint pain -Weight loss
History assessment (sexuality)
*In addition to the typical elements of a history, "the five P's" of a sexual history are... -Partners -Practices -Protection from infection -Past history of infection -Prevention of pregnancy
Stage 4 peripheral arterial disease (PAD) assessment
*Necrosis/gangrene -Ulcers and blackened distal tissue -Odor
Stage 3 peripheral arterial disease (PAD) assessment
*Rest pain -Pain while resting -Numbness/burning in distal portion of the extremity relived by dependent position (legs dangling off of bed)
Heat exhaustion signs/symptoms
*Result of dehydration -Headache -Weakness -Nausea -Vomiting -Temp may not be elevated *Warning sign, can lead to heat stroke if not treated
Medications for hyperthermia/fever
*Treatment is not always indicated (fever not harmful until 41°C (105.9°F) -Acetaminophen -NSAIDS -Aspirin (assoc/w Reye syndrome (do NOT use for children))
Antepartum fetal surveillance: non-stress test (NST)
*for "further testing" -Evaluates fetal heart rate (FHR) accelerations, with or without fetal movement -Fetal heart rate reactivity with accelerations & variability is a reassuring sign -Reactivity is associated with adequate fetal oxygenation and intact neural pathways -Fetal heart rate reactivity may not develop until 32 weeks in the fetus -Done at 32+ weeks
Intermediate insulin action
-1-3 hour onset -4-15 hour peak -Lowers blood glucose
Long acting insulin action
-1-4 hour onset -duration: 24 hours -Lowers blood glucose
Short acting insulin action
-30 minute onset -2-5 hour peak -Lowers blood glucose
If hypoglycemic patient cannot swallow, what treatment would they receive?
-50% dextrose IV -Glucagon SQ
Skin freezes at what temperature?
-5°C (23°F)
Treatment for DKA
-8-10 L fluid replace losses (IV fluids with 0.9% normal saline to 0.45% saline) -Regular insulin infusions -Electrolyte monitoring (specifically potassium)
Treatment for HHS
-8-10 L fluid to replace losses (IV fluids with 0.9% normal saline to 0.45% saline) -Regular insulin infusions -Monitor potassium (decreases with aggressive rehydration) -Cardiac monitoring due to changes in potassium
Menopause (definition)
-A combination of endocrine, body, and psychological changes that occur at the end of the reproductive cycle -End of menstruation (2 months without menses) -The time that precedes the final menstrual period -Decrease/lack of estrogen -AKA: the climacteric or change of life
What tells the kidneys to hold onto fluids; causing fluid retention?
-ADH -Aldosterone
Low blood volume, low blood pressure, low blood sodium, or low blood oxygen stimulates release of ____ and ____
-ADH -Renin
Criteria for diagnoses of diabetes
-AIC >6.5% AND 1 of the following: -Symptoms of diabetes plus casual glucose >200 -Fasting plasma glucose >126 -2-hour OGTT >200
These hormones come from the heart in response to excess blood volume and stretching cardiac walls. These hormones promote sodium wasting and acts as a potent diuretic *volume wasting of Na and H2O
-ANP -BNP
What are the two peptide hormones?
-ANP -BNP
What hormones tell the kidneys to flush out fluids/volume?
-ANP -BNP
Examples of antiplatelets
-ASA (aspirin) -Clopidogrel
Probable indications of pregnancy
-Abdominal enlargement -Cervical softening -Uterine changes -Pregnancy tests
Severe hypothermia signs/symptoms
-Absence of respirations -Absence of pulse -Ventricular fibrillation -Dilated/unresponsive pupils -Coma -Cardiac arrest
Treatment of fluid volume excess
-Accurately record intake and output as indicated -Weigh daily -Monitor vital signs, lab values & LOC -Reposition every 2 hours
Treatment of fluid volume deficit
-Accurately record intake and output as indicated -Weigh daily -Monitor vital signs, lab values & LOC -Reposition every 2 hours -Institute safety prec: teach prevention of orthostatic hypotension
Hyperpituitarism can lead to what?
-Acromegaly (occurs in adults) -Gigantism (occurs in children)
Two types of graft-versus-host disease (GVHD)
-Acute -Chronic
Types of leukemia
-Acute lymphocytic -Acute lymphocytic -Chronic myeloid -Chronic myeloid
If a hypoglycemic patient is conscious and alert, how would you treat them?
-Administer 25-50% glucose solution (gels, tabs) -15 g of rapid-acting sugar, wait 15, 15 g more
Considerations for chemotherapeutic drugs
-Administration of chemotherapy requires precautions to protect self and others -Many chemotherapeutic drugs are vesicants -Chemotherapeutic drugs are frequently given through central venous access devices -Oral and venous routes of administration are most common
Populations at greatest risk (sexuality)
-Adolescents (peer pressure) -Disabilities (cognitive, developmental, and physical) *usually overlooked when it comes to sexuality -Newly unpartnered (STIs, wanting to have a good time) -Sexual orientation and identification (lesbian, gay, bisexual, queer, transgender) *engage in more high-risk sexual activities
Individual risk factors for developing cancer
-Advanced age -Certain forms have a genetic component (skin, ovarian, breast, prostate, colon) -Low socioeconomic status (lack of healthcare coverage increases risk) -Smoking/tobacco -Infectious agents -Exposure to environmental carcinogens (sunlight, air pollutants, soil, water, food, (or medical treatments such as medications or radiation)) -Poor nutrition -Sedentary lifestyle -Hormone replacement therapy
Post-menopause
-After menses have ceased for one year -Vaginal bleeding must always be investigated at this stage
Factors that increase risk of heat-related injuries
-Age -Obesity -Medications -Mental health illnesses -Homelessness -Alcohol/substance abuse -Working/athletes outside -Military (very young and very old)
Risk factors for impaired perfusion
-Age -Gender -Family history -Lifestyle -Immobility -Stress -High cholesterol -ETOH use
Risk factors for colorectal cancer
-Age >50 -Ulcerative colitis1 -Genetic predisposition (individuals with a first degree relative have 3-4x the risk for developing the disease) -Men -Personal/family history of cancer -IBS (irritable bowel syndrome) -Crohn's disease -Smoking -Obesity -Physical inactivity -Heavy alcohol consumption -High fat diet
Examples of SABAs
-Albuterol -Levalbuterol -Proair
Two types of bone marrow transplant (BMT)
-Allogeneic -Autologous
Stem cell transplant (SCT)
-Alternative to BMT -Complete, sustained replacement of blood cell lines with cells from donor stem cells (RBCs, WBCs, platelets) -Donors must have tissue closely matched to recipient's -Hematopoietic growth factor administered to donor before harvesting to increase concentration of stem cells in peripheral blood
Presumptive indications of pregnancy
-Amenorrhea -Nausea and vomiting -Fatigue -Urinary frequency -Breast and skin changes -Vaginal and cervical color changes (Chadwick's sign) -Fetal movement (quickening) *noticed 16-20 weeks
Examples of Calcium channel blockers
-Amlodopine -Diltiazem -Verapamil
Sentinel lymph node biopsy
-Analyzes for lymph node involvement -Inject dye (which will follow the path of cancer cells)
Chemotherapy side effects
-Anemia (bone marrow suppression (decreases blood production)) -Neutropenia (decreased numbers of neutrophil white blood cells) (reduced immunity/susceptible to infections) -Thrombocytopenia (decreased number of platelets (risk for bleeding)) -Nausea -Epistaxis (nose bleeds) -Vomiting -Alopecia -Mucositis (open sores/ulcers of the mucous membranes) -Skin changes -Anxiety -Sleep disturbances -Altered bowel elimination -Changes in cognitive function
What medications can increase the risk of dehydration?
-Antacids -Diuretics -Laxatives
What are the causes of episodic erectile dysfunction?
-Anxiety -Fatigue -Depression -Negative body image -Privacy -Trust
Amniocentesis
-Aspiration of amniotic fluid from the sac for further examination -Second trimester amniocentesis (performed between 15 and 20 weeks / chromosomal or biochemical abnormalities or neural tube defects) -Third trimester amniocentesis (performed during the third trimester / used to determine fetal lung maturity (LS ratio) or hemolytic disease)
Antiplatelets drug examples for peripheral venous disease (PVD)
-Aspirin -P2Y12 inhibitor (clopidogrel) *inhibits platelet aggression
Arteriosclerosis/atherosclerosis assessment
-Assess blood pressure in both arms -Palpate carotid arteries separately -Capillary refill -Bruits -Cholesterol and triglycerides
Chronic lymphocytic leukemia (CLL)
-Associated with a genetic predisposition -Survival time can extend 10 years or more in patients diagnosed with early-stage disease
Positive indications of pregnancy
-Auscultation of fetal heart sounds -Fetal movements felt by examiner -Visualization of fetus
Hyperthermia can be a response to what?
-Bacterial or viral infections (fever) -Exposure to excessive heat (hyperthermia) -Tissue breakdown following myocardial infarction (MI), malignancy, surgery, trauma
Factors affecting heat production
-Basal metabolism -Increased muscular activity (shivering) -Thyroxine and epinephrine release (stimulating effects on metabolic rate) (AKA chemical thermogenesis) -Temperature effect on cells
Neoplasm (tumor) (2 types)
-Benign (non-cancerous) -Malignant (cancerous)
Manifestations of hypernatremia
-Big and bloated -Edema -Decreased urine -Thirst -Dry mucus membranes -Restlessness
Mechanism of action for Beta adrenergic blockers
-Blocks epinephrine and norepinephrine -Decreases HR
Mechanism of action for anti-cholingerics
-Blocks parasympathetic nervous system -Prevents asthma attacks/COPD bronchospasm
What happens in the body when there is a decrease in temperature?
-Blood vessels constrict (heat is trapped in deeper tissues) -Sweat glands become less active -Skeletal muscles contract (causing shivering)
What happens in the body when there is an increase in temperature?
-Blood vessels dilate (giving flushed appearance) -Sweat glands become more active
Thermoregulation (definition)
-Body process that balances heat production and heat loss -The process of maintaining the core body temperature at a nearly constant value
Common treatments for leukemia
-Bone marrow transplant (BMT) -Stem cell transplant (SCT)
Magnesium is primarily stored in the ___ and ___
-Bones -Cartilage
Peripheral vascular disease in relation to diabetes (macrovascular)
-Both types of diabetes; greater with type 2 -Peripheral vascular insufficiency with intermittent claudication -Ulcerations -Gangrene -Amputation
Breast changes (reproduction)
-Breasts change in size and appearance (may result in striae (stretch marks)) -Estrogen stimulates growth of mammary tissue -Progesterone stimulates growth of lobes, lobules, and alveoli (become highly vascular, striae gravidarum may appear) -Colostrum (thick yellow fluid aka "first milk") is present at 12-16 weeks of pregnancy
Asthma definition
-Bronchoconstriction -mucus production -inflammation (persistent inflammation of lungs characterized by recurrent episodes of -shortness of breath -chest tightness -coughing (especially at night) -wheezing)
Treatments for osteoporosis
-Calcitonin -Bisphosphonates (inhibit osteoblasts (cells that break down the bones)) -Hormone replacement medications (inhibit bone resorption) *increase risk of cancer -Daily calcium supplements along with vitamin D (vitamin D is needed for calcium to be absorbed) -Weight bearing exercises (increases bone density and builds muscle mass)
Examples of Angiotensin converting enzyme inhibitors (ACEs)
-Captopril -Enalapril -Lisinopril
Nursing considerations for hypomagnesemia
-Cardiac monitoring (due to decrease potassium when magnesium is low) -Seizure precautions
Examples of non-selective Beta-adrenergic blockers
-Carvedilol -Labetalol -Propranolol -Nadolol
Effects of female hormones (estrogen)
-Causes uterus to increase in size, weight -Expands blood supply -Aids in developing ductal system in the breasts -Associated with hyperpigmentation, vascular changes in skin -Increases activity of salivary glands, hyperemia of the gums and nasal mucous membranes
Triple negative breast cancer (TNBC)
-Cells test negative for receptors commonly found in breast cancer -Grows rapidly -Often found in with BRCA mutation who are premenopausal
Which STD is Ophthalmia neonatorum a common result in infants which manifests 1-4 days after birth as thick, purulent discharge from the eyes. If untreated, this can lead to blindness
-Chlamydia -Gonorrhea
Which STD is diagnosed by culture, nucleic acid amplifications tests (NAATs), or urine swab?
-Chlamydia -Gonorrhea
Which STD may be asymptomatic?
-Chlamydia -Gonorrhea
Which infections can be diagnosed using a nucleic acid amplified test?
-Chlamydia -Gonorrhea -Trichomoniasi
Which STD is bacterial?
-Chlamydia -Syphilis -Gonorrhea
Which STD must be reported to the local health department?
-Chlamydia -Syphilis -Gonorrhea
Chronic myeloid leukemia (CML) 3 phases
-Chronic (slow growing with mild manifestations that respond to therapy) -Accelerated (more rapid growing with more severe manifestations, increased blast cells, and failure to respond to therapy) -Blast (very aggressive leukemia with high percentage of blast cells and promyelocytes that spread to other organs)
Classic heat stroke caused by...
-Chronic exposure to heat/humidity -Over a period of time
Fetal portion of placenta
-Chronic villi and their circulation -Covered by amnion, giving it shiny gray appearance
Antitussive examples
-Codeine -Dextromethorphan
Examples of biologic therapy
-Colony-stimulating factors -Gene therapy -Monoclonal antibiotics -Nonspecific immunomodulating agents -Angiogenesis -Vaccines
Chromosomes
-Composed of genes that are composed of DNA -23 pairs -Karyotype (individual's collection of chromosomes)
Peripheral venous disease (PVD) interventions
-Compression stockings -Compression pumps -Elevate legs (20 mins, 4-5 times/day) -Wound therapy -Lifestyle changes
Methods of heat transfer
-Conduction -Convection -Radiation -Evaporation
This STD is viral
-Condylomata Acuminata (genital warts) -Genital herpes
Examples of hypertonic dehydration
-Confusion -Dementia -Decreased intake
Toddler (sexuality)
-Continue to develop gender identity -Exploration is normal -Encourage contact with opposite gender if single parent
Treatment for hyperthermia
-Cooling blankets/fluids -Tepid sponge bath (increases heat loss through convection) -Monitor intake and output (I&O) -Monitor temperature every 2 hours -Provide oral care to moisten mucus membranes -Promote adequate fluid and nutritional intake -Strict electrolyte monitoring, renal, liver, cardiac function -Reduce coverings (blankets, clothing, etc.) -Oral or IV medication -Reduce physical activity to limit heat production -Adjust temperature in patient's room -Antipyretics as needed
· Cardiovascular disease in relation to diabetes (macrovascular)
-Coronary artery disease -Risk factor for development of myocardial infarction (MI)
Disorders of adrenal glands
-Cushing syndrome -Addison disease
Treatment for hypermagnesemia
-D/c meds or oral intake -Loop diuretics (if kidney function okay) -Hemodialysis (if severe)
Considerations for Calcium channel blockers
-DO NOT give with grapefruit juice -DO NOT give if HR <60 -Orthostatic hypotension -Angina
Causes of tachycardia
-Damage to heart from heart disease -Hypertension -Fever -Stress -Excess alcohol -Nicotine -Recreational drugs side effect of meds -Pain -Imbalance in electrolytes -Hyperthyroidism
Radiation pharmacologic management of leukemia
-Damages cellular DNA so it cannot multiply -Cells that divide rapidly (bone marrow/cancer cells) respond quickly -Normal cells affected but can recover
Maternal portion of placenta
-Decidua basalis and its circulation -Red, rough
Urinary frequency considerations (pregnancy)
-Decrease fluids in the evening -Perform Kegel exercises to maintain control -Common during 3rd trimester from uterine pressure on the bladder -Common during the first trimester due to hormonal changes, increased blood volume and changes in glomerular filtration rate -Avoid caffeinated beverages
Which change that occurs with aging increases the risk for hypothermia in older adults?
-Decreased amount of body fat -Diminished energy reserves -Chronic medical conditions
Manifestations of hypercalcemia
-Decreased neuroexcitability -Fatigue/weakness/decreased DTRs -Calcifications (eyes, kidney stones) -Confused/lethargic
Side effect of antidepressants (sexuality)
-Decreased sexual desire -Orgasmic delay/dysfunction -Delayed/failed ejaculation -Painful erection
Sex-linked recessive
-Disorders present on sex chromosome *Colorblindness
Food safety during pregnancy
-Do not eat shark, swordfish, mackerel, and tile fish -Do not eat raw or undercooked fish, meats, poultry, or eggs -Avoid luncheon meats and hot dogs (unless steaming hot) -Avoid soft cheeses (unless made with pasteurized milk) -Do not consume pate or meat spreads or raw (unpasteurized) milk products
Allele types
-Dominant -Recessive
Which treatment strategy would benefit a client diagnosed with chlamydia?
-Doxycycline -Azithromycin
Side effects of anti-cholinergics
-Dry mouth (candy, ice) -Tachycardia -Anxiety
Side effects of Angiotensin converting enzyme inhibitors (ACEs)
-Dry nagging cough -Edema -Hyperkalemia (avoid potassium) -Swelling of face and tongue -Hypotension -Angioedema
Noninvasive (in SITU) breast cancer
-Ductal carcinoma in situ (DCIS) -Lobular carcinoma in situ (LCIS)
Symptoms of peripheral venous disease (PVD)
-Dull leg discomfort -Lower leg edema -Reddish-brown discoloration -Irregular shaped ulcers -Cyanosis -Itching
Manifestations of hyperkalemia
-Dysrhythmias (tall peaked T waves, wide QRS) -Muscle twitching/parathesis/increased DTRs -Diarrhea/hyperactive bowels
Constipation considerations (pregnancy)
-Eat foods high in fiber -Restrict cheese consumption and reduce intake of sweets -Drink a minimum of 8 glasses of fluid daily -Walk, swim, or bike 1 mile per day -This can be exacerbated by side effects of iron and decreased physical activity
Signs/symptoms of leukemia
-Ecchymoses -Petechiae -Open infected lesions -Pallor of the conjunctivae, nail beds, palmar creases, and around the mouth -Bleeding gums -Anorexia -Weight loss -Enlarged liver and spleen (collection of blood cells) *usually chronic -Hematuria -Bone pain -Joint swelling and pain -Tachycardia at basal activity levels -Orthostatic hypotension -Palpitations -Dyspnea on exertion -Fatigue -Headache -Fever
These factors promote health regarding hormonal regulation
-Education -Diet -Exercise -Weight control -Injury avoidance (helmet use) -Avoidance of environmental hazards -Stress management -Maintaining routine sleep-wake patterns
Perioperative considerations: pre-op (breast cancer)
-Education -Support
What are the principal electrolytes that are apart of the extracellular fluid?
-Electrolytes -Sodium -Chloride -Bicarbonate
Lymphedema precautions
-Elevate arm -No blood pressure -No IV
Bleeding gums considerations (pregnancy)
-Encouraged to continue to regularly maintain oral hygiene (brushing and flossing), routine dental care should be continued as necessary -Increased levels of estrogen increase blood flow to gingival tissue. The increase of small blood vessels, hyperplasia, and edema can cause this
Considerations for patients with hypothermia
-Ensure dry environment and clothing -Warming blankets (bear hugging) -Caps/turbans -Warm environment (increase room temp) -Keep limbs close to body -Gentle handling to reduce risk of cardiac dysrhythmias -Patients who fail to be rewarmed may have hypothyroidism
Treatment for heat stroke
-Ensure patent airway -Remove from hot environment -Contact EMS -Do NOT give food/fluids (risk for aspiration)
Numeric chromosome abnormality
-Entire single chromosome added (trisomy) -Entire single chromosome missing (monosomy) -One or more added sets of chromosomes (polyploidy)
Menopause hormone therapy (MHT)
-Estrogen and progesterone are given to the woman who retains a uterus -Estrogen to those who have had a hysterectomy
Causes of actual sodium deficit
-Excessive diaphoresis -Diuretics (overuse) -Wound drainage -Decreased aldosterone -Kidney disease -NPO or low salt diet -Severe vomiting/diarrhea
Examples of hypotonic dehydration
-Excessive sweating -Heat stroke/exhaustion
Manifestations of hyponatremia
-Excitable membranes are less excitable -Confusion -Seizure precautions -Cerebral changes due to cerebral edema -Weakness -Decreased DTR -Nausea -Orthostatic hypotension -Weak thready pulse
Interventions for peripheral arterial disease (PAD)
-Exercise and positioning -Promoting vasodilation -Drug therapy -Percutaneous vascular intervention -Arterial revascularization -Encourage patients to wear socks
Signs/symptoms of hyperthyroidism
-Exophthalmos (protruding eyes) -Weight loss -Increased appetite -Hair loss -Hot flashes -Anxiety/tremors
Cardiovascular system (reproduction)
-Expanded blood volume increases cardiac output but not blood pressure -Supine hypotensive syndrome occurs because the gravid uterus partially occludes the vena cava and aorta when the mother is supine *corrected by position change (turn to lateral/side position) -Five major changes to blood flow -Plasma volume expansion results in physiologic anemia (diluted RBCs, NOT decreased count of RBCs) *iron intake is critical
Pre-school (sexuality)
-Explore own and others body parts -Learn correct names -Focus love for parent of opposite gender -Answer questions honestly and simply
Symptoms severe arterial disease
-Extremity is cold and gray-blue or darkened -Pallor may occur with extremity elevation -Dependent rubor/redness -Muscle atrophy
Risk factors for osteoporosis
-Family history -Late menarche -Early menopause -Smoking -ETOH use -Excessive caffeine -Inadequate calcium or vitamin D earlier in life
Risk factors for febrile seizures
-Family member with history of febrile seizures -First febrile seizure at <15 months -History of frequent seizures
Glucose tolerance test (GTT)
-Fasting -Drink 100 grams of glucose -Draw labs (Fasting, 1 hour, 2 hours, and 3 hours after drinking glucose) -Diagnoses for diabetes: Fasting glucose is >95 2 or more other values are abnormal (1 hour >180, 2 hour >155, 3 hour >140)
Risk factors for breast cancer
-Female -Age >65 -Early menarche or late menopause -Nulliparity or first pregnancy after 30 years -Personal history of breast cancer -Genetic risk factors -Breast density -Previous irradiation of chest area -Previous abnormal breast biopsy results -Long-term hormone replacement therapy with estrogen and progesterone -Excessive alcohol consumption -Overweight or obesity -Physical inactivity
If fetal heart rate does not accelerate with movement, then ____ & ____ are of concern
-Fetal hypoxia -Acidosis
Maternal assessment of fetal activity
-Fetal movement is indicative that baby is healthy -Decrease in fetal movement = let provider know -Can be done at about 16-20 weeks
Benign disorders of the breast
-Fibroadenoma -Fibrocystic breast changes -Ductal ectasia -Intraductal papilloma
Aromatase inhibitors (anastrozole, letrozole) *action
-First line treatment in postmenopausal women -Inhibits conversion of androgen to estrogen -Closely monitor for osteoporosis
Risk factors for hypertension in pregnancy
-First pregnancy -Men who have fathered one preeclamptic pregnancy -Age >35 -Anemia -Family history -Chronic hypertension -Chronic renal disease -Obesity -DM -Multifetal pregnancy
Side effects of sildenafil
-Flushing -Headache -Dyspepsia (pain in upper middle abdomen)
Mechanism of action for direct vasodilators
-For hypertensive crisis -Relax peripheral smooth muscle -Decrease blood pressure
Chemotherapy (colon cancer)
-For stage II or III -When combined with radiation, reduces recurrence and prolongs survival
What does GTPAL stand for?
-G: gravidity (number of pregnancies including current) -T: term (number of pregnancies carried to 37+ weeks) -P: preterm (number of pregnancies carried between 20 and 36 weeks) -A: abortion (number of losses before 20 weeks) -L: living (number of living children)
Etiology and risk of leukemia
-Genetic and environmental factors -Smoking -Immune deficiency -Chromosomal defects -Chemotherapeutic agents -Damage to genes that control cell growth -Risk factors (ionizing radiation, viral infection, exposure to chemicals and drugs) -Most common types (Children: acute lymphocytic leukemia (ALL), Adults: acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL)
Screening methods for malignant hyperthermia
-Genetic testing -Muscle biopsy/caffeine halothane contracture test (CHCT)
May cause dysuria and urinary retention
-Genital herpes -Gonorrhea
What are the counterregulatory hormones that raise glucose?
-Glucagon -Cortisol
Nursing care regarding infection (leukemia)
-Handwashing -Strict aseptic technique (dressings, etc.) -Changes in WBC function impair immune, inflammatory responses -Chemotherapy, radiation therapy further depresses bone marrow function, increasing risk for infection -Neutropenia can occur which will result in reverse isolation (protect patient from others) *no visitors with communicable diseases
Arteriosclerosis (definition)
-Hardening of the arteries -Often associated with aging
Newborn/infants lifespan considerations (thermoregulation)
-Have underdeveloped temperature regulation capacity -Produce sufficient body heat, but lack the ability to conserve heat -Large body surface area makes newborns more susceptible to excessive temperature loss -Have brown adipose tissue (helps protect organs from extreme temperature changes and produces heat, which transfers to the peripheral circulation) -Affected by heat loss through conduction because their vessels are so close to their skin -Keep warm, dry to prevent hypothermia -Newborn (<30 days) with fever need physician evaluation immediately -Chilling can cause signs of respiratory distress -Limited insulating subcutaneous fat -Mottled skin = warm the environment -Brown adipose tissue (brown fat) = Source of heat for infant (increased metabolic activity)
Febrile signs/symptoms
-Headache -Elevated heart rate -Flushed -Warm to touch -Fatigue -Body aches -Dry skin/mucus membranes -Diaphoresis -Decreased urine output -Seizures (hyperpyrexia >41.5°C)
Hyperthermia examples
-Heat exhaustion -Heat stroke
Severe hypothermia treatment
-Hemodialysis -Peritoneal dialysis -Colonic irrigation (to increase core body temperature)
Drug therapy for peripheral arterial disease (PAD)
-Hemorheologic (pentoxifylline) -Antiplatelet (aspirin (ASA), clopidogrel)
Causes of excessive fluid loss (FVD)
-Hemorrhage -GI suctioning -Intestinal fistulas -Vomiting -Diarrhea -Renal disease -Endocrine issues -Abuse of laxatives -Heat
Examples of isotonic fluid volume deficit
-Hemorrhage -Polyuria -V/D -Chron's
Examples of anticoagulants
-Heparin -LMWH -Warfarin
Anticoagulant drug examples for peripheral venous disease (PVD)
-Heparin (IV, SQ) -Low-molecular weight heparin (SQ)
Drive to breathe depends on
-High level of CO2 (carbon dioxide) in arterial blood -Low level of O2 (oxygen)
Individual risk factors (sexuality)
-High risk sexual behavior (multiple and casual partners, failure to practice safe-sex measures) -Use of alcohol, marijuana, or other illicit substances *impaired coordination and judgement -Underlying medical conditions and medications *can affect sexual function
Risk factors for type 2 diabetes
-History of diabetes in parents or siblings -Obesity/physical inactivity -Race/ethnicity -History of gestational diabetes, polycystic ovary syndrome, hypertension
Which contraceptives have an advantage of a low long-term cost?
-Hormone implant -Sterilization -IUD
Which contraceptives have the advantage of causing amenorrhea with continued use?
-Hormone injection -IUD
Examples of direct vasodilators
-Hydralazine -Minoxidil -Nitroglycerin
Causes of actual sodium excess
-Hyperaldosteronism -Kidney failure -Corticosteroids -Cushing syndrome -Excessive ingestion of sodium -Excessive administration of sodium fluid
Cushing syndrome
-Hypercortisolism -Results from too much cortisol
Type 1 diabetes is characterized by
-Hyperglycemia -Breakdown of body fats and proteins -Development of ketosis
Causes of relative sodium deficit
-Hyperglycemia -Excessive hypo sodium fluids -Excess water intake -Burns
Disorders of the parathyroid gland
-Hyperparathyroid -Hypoparathyroid
Manifestations of hypomagnesemia
-Increased membrane excitability -Nerve impulses -Paresthesia's and muscle spasms and increased DTRs -Positive trousseau's or chvostek's signs
Manifestations of hypocalcemia
-Increased neuroexcitability -Hyperactive reflexes -Paresthesia's initially that can lead to muscle spasms -Brittle bones/osteoporosis -Hyperactive bowels/diarrhea -Positive trousseau's or Chvostek's signs
Mechanism of action for corticosteroids
-Increases glucose -Prevents asthma attacks caused by inflammation or allergies -Adrenal insufficiency
Osteoporosis (definition)
-Increases spaces in the bone -Reduced bone density -Susceptibility to fractures -Decrease of estrogen accelerates bone loss
Malignant hyperthermia (definition)
-Inherited genetic disorder that is potentially fatal -Occurs when a patient is exposed to volatile inhalation anesthetic gases and succinylcholine *usually under general anesthesia when exposed (occurs in operating room) -Causes rapid rise in temperature; up to hyperpyrexia
Side effect of narcotics (sexuality)
-Inhibited sexual desire and response -Erectile and ejaculatory dysfunctions
· Mechanism of action for Angiotensin converting enzyme inhibitors (ACEs)
-Inhibits angiotensin 1 to angiotensin 2, blocking vasoconstriction; causing arterial dilation -Decreases blood pressure -Suppresses RAAS
Interventions for seizures
-Initiate preventative measures (pad rails) -Monitor for signs of impending seizure -Prevent seizure-related injury -Protect the woman during a seizure (lay on LEFT side (takes pressure off heart)) -Support the family -Suctioning -Monitor for signs of magnesium toxicity
Older adults (sexuality)
-Interest in sexual activity continues -Sexual activity may be less frequent -Vaginal secretions diminish -Breast atrophy -Fewer sperm produced -More time needed to achieve erection -Privacy may be of concern -Educate about enhancement products
Components of extracellular fluid
-Interstitial fluid -Intravascular fluid (plasma) -Transcellular and lymph fluids
Types of breast cancer
-Invasive -Noninvasive -Triple negative breast cancer (TNBC) -Paget disease
Invasive breast cancer
-Invasive ductal carcinoma -Inflammatory breast cancer (IBC)
Risk factors for leukemia
-Ionizing radiation -Viral infection -Exposure to chemicals and drugs
Specific manifestations of fluid volume deficit for newborns, infants and children/adolescents
-Irritable -Lethargic -Sunken fontanels & eyes -No tears -Vomiting -Diarrhea -Fever
Signs/symptoms of hyperparathyroidism
-Kidney stones -Skeletal pain -Pathological fractures -Weight loss -Anorexia -Constipation -Confusion
Organ affected by preeclampsia
-Kidneys (increase BUN, proteinuria, creatinine, acid levels, monitor urinary output) -Livers -Eyes -Brain (seizures (eclampsia))
Radiation action on breast cancer
-Kill cells near original tumor -Localized
Chemotherapy action on breast cancer
-Kills undetected breast cancer cells -Systemic
Fertility issues can be cause by what hormones within the anterior pituitary?
-LH -FSH
Causes of insufficient intake of fluids (FVD)
-Lack of fluid access -Oral trauma -Swallowing difficulty -Altered thirst mechanism -Confusion -Mobility issues
Mechanism of action for Xanthines
-Last resort med for asthma -Relaxes smooth muscles in the airway
Nutrition for client with peripheral arterial disease
-Limit salt intake -Eat more whole grains -Use liquid vegetable oils -Avoid processed meats
Autosomal dominant
-Located on numbered chromosome, a single copy of the disease associated mutation is enough to cause the disease *EX: -Huntington's disease (ONE copy of the gene is needed) -Bb/BB
Physical assessment (breast cancer)
-Location, shape, size, consistency, mobility of mass -Skin changes -Enlargement of nodes -Pain or tenderness
Pharmacologic therapy for fluid volume excess
-Loop diuretics (Lasix) -Thiazide-type diuretics (HCTZ) -Potassium-sparing diuretics (Aldactone/spironolactone)
Examples of Angiotensin receptor blockers (ARBs)
-Losartan -Valsartan
Poor weight gain in pregnant women is associated with
-Low birth weight infants -Preterm birth -SGA
Decreased RBCs (anemia) may result in what?
-Low oxygenation -Fatigue -Pallor
Back pain considerations (pregnancy)
-Lumbar lordosis occurs to counter the weight of the uterus -Result of increased pressure due to the enlarging uterus, lordosis, relaxed ligaments, and muscle strain associated with pregnancy. Common during 3rd trimester -Avoid bending over -Proper body mechanics -Wear supportive, low-heeled shoes -Perform exercises such as tailor sitting, shoulder circling and pelvic rocking
Cell type of leukemia is classified as...
-Lymphocytic vs myeloid *Immature lymphocytes infiltrate spleen, lymph nodes, CNS *Myeloid stem cells interfering with maturation of all blood cells granulocytes, RBCs, and thrombocytes
Most patients who experience an acute peripheral arterial occlusion also had experience with a recent...
-MI -atrial fibrillation
Excessive weight gain in pregnant women may lead to...
-Macrosomia -Cesarean birth -Low Apgar scores -Hypoglycemia -Overweight in children
Treatment of HELLP
-Magnesium sulfate to reduce seizure -Corticosteroids -Blood transfusion (if platelets get really low) -BP control -Fetal monitoring *Same as Eclampsia
Progesterone does what throughout pregnancy?
-Maintains the uterine lining -Prevents contractions -Helps prepare breasts for lactation
Secondary prevention for cancer
-Mammogram -Prostate-specific antigen -Colonoscopy -Guaiac test for occult blood (colon cancer)
Considerations for Beta adrenergic blockers
-Masks symptoms of hypoglycemia -DO NOT take with asthma due to bronchoconstriction -Monitor glucose -DO NOT give if HR <60
Location of PVD lesions
-Medial parts of lower leg -Medial ankle region
Types of oral hypoglycemic drugs (type 2 diabetes)
-Metformin -Glipzide -Proglitazone
Examples of selective Beta-adrenergic blockers
-Metoprolol -Atenolol
Nausea/vomiting considerations (pregnancy)
-Notify health care provider if this becomes severe or develop signs of dehydration -Avoid foods with strong odors -Consume small, frequent meals -Eat foods containing ginger or peppermint -Eat dry crackers and toast before getting up in the morning -Avoid consuming liquids and solids at the same time -Acupressure wristbands -Cause is not fully known, but theories include the interplay of hormonal changes (hCG, estrogen), slowed peristalsis, and periodic hypoglycemia
Superficial frostbite (frostnip) signs/symptoms
-Numbness -Itching -Prickling
Signs/symptoms of hypoparathyroidism
-Numbness and tingling -Muscle cramps -Tetany -Hypotension -Anxiety -Positive trousseau's or chvostek's sign
Chromosome abnormalities examples
-Numeric -Structural
Risk factors for essential hypertension
-Obesity -Smoking -Stress -Family history
Effects of female hormones (progesterone)
-Often called hormone of pregnancy: maintains pregnancy -Prepares breasts for lactation -Relaxes smooth muscle -Facilitates deposit of maternal fat stores, which provide reserve of energy for pregnancy and lactation
Clinical manifestations of severe FVD
-Oliguria -Coma -Falling systolic/diastolic pressure
Rehydration can be done by these two methods...
-Oral -IV
Invasive *ductal carcinoma
-Originates in mammary ducts and break through wall of ducts into surrounding tissue -Irregular poorly defined mass -Fibrosis develops around the cancer -Peau d'orange
What happens in the body when there is a decreased volume of extracellular fluid and an increase osmolality of extracellular fluid?
-Osmoreceptors in hypothalamic thirst center are stimulated -Decreased saliva secretion -Dry mouth -Sensation of thirst *Once the person drinks water, it results in increased volume of extracellular fluid and decreased osmolality of extracellular fluid
What solutes make up intracellular fluid?
-Oxygen -Electrolytes -Glucose
Heat stroke hospital care
-Oxygen -Large bore IV's -Normal saline (cooled) -Cooling blanket -Lab tests -Internal temp monitoring
Antepartum fetal surveillance: contraction stress test (CST)
-Oxytocin challenge test -Used to determine how the fetal heart responds to uterine contractions that temporarily decrease placental blood flow -Cannot be done if stimulated uterine contractions are contraindicated -Nipple stimulation or low-dose oxytocin to trigger a contraction -Can be done in 3rd trimester -Positive test = placenta can support life for at least one more week
Presentation of acute peripheral arterial occlusion
-Pain -Pallor -Pulselessness -Paralysis -Paresthesia -Poikilothermy (cool extremity)
Hospital care for frostbite
-Pain medications -Anti-inflammatories -Tetanus immunization -Arteriography -Rewarming whirlpool therapy (no massage of affected areas)
Treatment for hyperparathyroidism
-Parathyroidectomy -Diet increase fiber and moderate calcium -IV calcitonin/phosphates
If a hypoglycemic patient has an altered level of consciousness, how would you treat them?
-Parenteral glucose (D50, D10, D5) via IV -Glucagon via SQ injection
Deeper frostbite signs/symptoms
-Paresthesia -Stiffness
Structural chromosome abnormality
-Part of a chromosome missing or added -Rearrangements of material within chromosomes -Two chromosomes that adhere to each other -Fragility of a specific site on the chromosome
Examples of LABAs
-Salmeterol -Formoterol -Indacterol -Albuterol (PO version)
Chorionic Villus Sampling
-Sample of chorionic villi -10-13 weeks -Risk for infection & pregnancy loss -Can be done before an amniocentesis
Clinical management, secondary prevention (sexuality)
-Screening for sexually transmitted infections (STIs) -Screening for intimate partner violence -Cervical cytologic screening (pap test) -HIV screening
Two types of Beta-adrenergic blockers
-Selective -Non-selective
Defining sexuality
-Sense of being -Unique and individual -Dynamic -Nature of relation to self and others
Status asthmaticus is a...
-Severe life-threatening asthma attack -intensifies once begun -usually does not respond to common treatment -can develop pneumothorax, cardiac, or respiratory arrest *prepare for emergency intubation
Adults (sexuality)
-Sexual activity is common -Establish own lifestyle and values -Form long term intimate relationships -Encourage communication among partners -STI
Infancy (sexuality)
-Sexual response is present before birth -Self manipulation is normal and common
Round ligament pain
-Sharp pain in the side or inguinal area usually on the right-side cause by softening and stretching of the ligament from hormones and uterine growth -Practice good body mechanics -Squat when picking items up (do not bend at the waist) -Avoid stretching and twisting at the same time -Bend towards the pain, squat or bring the knees up to the chest
General signs/symptoms of hypothermia
-Shivering -Slow capillary refill -Muscular rigidity -Cool, pale skin -Sluggish thought -Poor coordination -Dysrhythmias
Three physiologic responses to cold (falls under "sensors detect cold"
-Shivering (increases heat production) -Sweating (inhibited to decrease loss) -Vasoconstriction (decreases heat loss)
These medications end in "-ol"
-Short acting beta 2 agonist (SABA) -Long acting beta 2 agonist (LABA)
Respiratory system (reproduction)
-Slight hyperventilation and decreased airway resistance allow oxygen needs to be met -Oxygen consumption increases by about 20% in pregnancy (half of this oxygen is used by the uterus, fetus, and placenta; the remainder is consumed by breast tissue and increased cardiac, renal, and respiratory maternal demands) -Hormones play a role in airway resistance
Hypothyroidism results in...
-Too little TH -Decreased energy
Hyperparathyroidism results in
-Too much PTH -Increased calcium/decreased phosphorus
Severe/prolonged causes of hypercalcemia
-Slowed cardiac impulses -Hypoactive bowels/constipation
Primary prevention for cancer
-Smoking cessation -Avoiding excessive sun exposure -Regular physical activity -Balanced diet -Prophylactic surgery
Vesicular sounds
-Soft low pitched -heard over peripheral lung fields -typically longer on inhalation than exhalation
Components of intracellular fluid
-Solutes -Cations -Anions
Methods of contraception
-Sterilization -Hormonal contraceptives (patches, injections, oral) -Intrauterine devices (IUD) -Barrier methods (chemical barriers (spermicide) and mechanical barriers (condoms)) -Natural family planning (tracking menstrual cycle) -Least reliable methods of contraception (breastfeeding and coitus interruptus ("pull out" method)
Which contraceptives have the disadvantage of being expensive initially?
-Sterilization -IUD
Treatment for graft-versus-host disease (GVHD)
-Steroids -Antibiotics -Immunosuppressants
Exertional heat stroke
-Sudden onset -Strenuous activity -Too much clothing
Peripheral venous disease (PVD) ulcer appearance
-Swollen w/ drainage -Granulation present (deep pink to red) -Edges irregular -Shallow
Symptoms of bradycardia
-Syncope -Dizziness -Chest pain -Shortness of breath -Exercise intolerance -Cool clammy skin
Peripheral arterial disease (PAD) (definition)
-Systemic atherosclerosis -Alters natural flow of blood through arteries and veins of peripheral circulation
Nursing interventions for anti-cholinergics
-Takes 60-90 mins to be effective -Give ice or candy for dry mouth
4 mechanisms that influence blood pressure
-The arterial baroreceptor system -Regulation of body fluid volume -The renin-angiotensin-aldosterone system -Vascular autoregulation
Asthma affects
-The bronchioles -upper airway -NOT the alveoli
If pregnancy does not occur (what happens?)
-The corpus luteum dies (around day 22/28-day cycle) -There's a drop in progesterone levels which causes the lining of the uterus to shed (menstruation)
Examples of Xanthines
-Theophylline -Aminophylline
Examples of diuretics
-Thiazide (HCTZ) -Loop (Furosemide (Lasix)) -Potassium sparing (Spironolactone (Aldactone))
Treatment for hyperthyroidism
-Thyroidectomy -TH blocking medications -Radioactive iodine therapy
Hypoparathyroidism results in
-Too little PTH -Decreased calcium/increased phosphorus
Heartburn considerations
-Wear lose fitting clothes -Do not eat or drink just before bedtime -Consume small, frequent meals -Elevate head by sleeping with extra pillows -Avoid foods that trigger symptoms such as fried/fatty foods, acidic foods, and spicy foods -The lower esophageal sphincter is relaxed, GI motility is slower, and the angle of gastroesophageal junction is changed due to stomach displacement by the enlarged uterus
Health promotion for hypertension
-Weight reduction -DASH diet -Reduce intake of dietary sodium -Increase physical activity
Glucose 6 phosphate dehydrogenase anemia (G6PD)
-X linked recessive deficiency of the enzyme G6PD -Triggered by stressors
Antiplatelet side effects
-administer drug with meals -if platelets are LOW do not give
Etiology of COPD
-age 50+ current or former smoker with 20 pack/year history -mortality rates for men and women are equal -not curable, but symptoms can be managed -other causes (exposures to occupational irritants, indoor and outdoor air pollution, genetic factor)
Preload (definition)
-amount of cardiac muscle tension (or stretch) at the end of diastole -blood in ventricles
Medications for peripheral vascular disease
-anticoagulants -antiplatelets
Atelectasis vs pneumothorax
-atelectasis (collapse of alveoli) -pneumothorax (collapse of the entire lung)
Hemolytic anemia types
-autoimmune hemolytic anemia -sickle cell disease -Glucose 6 phosphate dehydrogenase anemia (G6PD) *premature destruction of RBCs
Sickle cell disease
-autosomal recessive inheritance -results in premature breakdown of RBCs -priority: pain management (chronic pain condition
Onset of asthma may...
-be abrupt or insidious -may subside rapidly or persist for hours or days
Sources of iron
-beef -chicken -egg yolk -clams -oysters -turkey -veal -bran flakes -brown rice -whole grain breads -dried beans -leafy greens -dried fruits -oatmeal
What treatment would you give for hypertensive crisis?
-beta blocker -vasodilator
Anemias are categorized by causes such as...
-blood loss -nutritional -hemolytic -bone marrow suppression (aplastic) *each type has a specific pathophysiology, manifestations
Aplastic anemia
-bone marrow fails to produce all three types of blood cells -pancytopenia (deficiency in red and white blood cells) -normal bone marrow is replaced by fat -50% idiopathic (stem cell damage due to radiation, chemical substances, arsenic, pesticides, chemo, viral infections)
Symptoms of iron deficiency anemia
-brittle spoon-shaped nails -smooth sore tongue -pica (eating non-food items)
Iron deficiency anemia
-cannot synthesize hemoglobin without iron -need nutritional intake
Prevention of COPD
-cessation of smoking -decrease exposure to: secondhand smoke, occupational respiratory irritants, air pollutants -Hispanic patients at higher risk (tobacco use leading preventable cause of death)
Initial symptoms long before changes in pulmonary function are...
-chronic cough -sputum production -dyspnea w/ exertion
Rhonchi (adventitious breath sounds)
-coarse low pitched -continue through inspiration -blockage of large airway passages
Oral supplemental iron may cause
-constipation -nausea -heartburn -life threatening hypersensitivity reaction when administered parenterally (rare)
Symptoms of acute episode of asthma
-coughing -wheezing -shortness of breath -chest tightness -tachypnea -tachycardia -anxiety -apprehension
Side effect of anticonvulsants (sexuality)
-decreased sexual desire -reduced response
Emphysema is...
-destruction of walls of alveoli -enlargement of abnormal air spaces within alveoli (air trapping/dead space)
Risk factors/causes of anemia
-dietary problems -genetic disorders -bone marrow disease -excessive bleeding -gastric surgery -kidney disease -alcohol abuse -conditions that cause excessive bleeding (ulcers, esophageal varices, heavy menstruation, cancers etc.)
Chronic bronchitis is...
-disorder of excessive bronchial mucus secretion -productive cough lasting >3 months in 2 consecutive years
Symptoms of tachycardia
-dizziness -shortness of breath -lightheadedness -rapid pulse -palpitations -chest pain -syncope
Postural drainage
-drainage by gravity of secretions from lung segments -to decrease risk of infection, airway obstruction -wide variety of positions necessary to drain all parts of lung (only positions used for specific areas used at any given time) -lower lobes require more frequent drainage -done 2-3 times/day depending on degree of lung congestion -may be preceded by administration of bronchodilator or nebulization therapy
What are the 4 metabolic problems that DKA involves?
1. Hyperosmolarity (from hyperglycemia and dehydration) 2. Metabolic acidosis (from an accumulation of ketoacids) 3. Extracellular volume depletion (from osmotic diuresis) 4. Electrolyte imbalances from osmotic diuresis
Sequence of events occurring during a fever in chronological order
1. Immune system response is triggered 2. The set point of the hypothalamus is raised 3. Body temperature is increased 4. Pyrogens are destroyed 5. Heat loss responses are initiated
4 stages of blood pressure
1. Normal 2. Elevated 3. Stage 1 hypertension 4. Stage 2 hypertension
3 components of the regulatory system
1. Sensors detect heat (send signals to effector system to decrease heat production, increase heat loss) 2. Sensors detect cold (send signals to effector system to increase heat production, decrease heat loss) 3. Hypothalamus (controls core temperature)
Nasal cannula flow rate
1-6 L
Specific gravity normal range
1.005-1.030
Magnesium (Mg2+) normal range
1.8-2.6 mEq/L
Components of ovarian cycle
1.Follicular phase 2.Ovulation 3.Luteal phase
What fraction of the body is intracellular fluid?
2/3
What percentage of fluids make up the intravascular space?
20%
Dietary fiber intake should be __ g/day
20-35 g/day
Total cholesterol should be less than
200
Normal ABG HCO3
22-26
How many ml of fluid should an individual intake each day?
2300 ml
If the mother is 24 weeks pregnant, the fundal height should be around what?
24 cm *Weeks pregnant = fundal height estimate
The lifespan of a typical egg is...
24 hours
Nasal cannula FIO2
24-45%
Venturi mask FIO2
24-50%
How many liters does intracellular space make up?
25 liters
A woman of normal weight is expected to gain __-__ pounds during pregnancy
25-35 pounds
Osmolarity normal range
270-300 mOsm/L
An underweight woman is expected to gain __-__ pounds during pregnancy
28-40 pounds
Right lung lobes
3 (upper, middle, lower)
Example of hypertonic solution
3% sodium (higher osmolality) *pulls fluid into vascular (increases extracellular)
Allogeneic BMT
Bone marrow cells from donor with closely matched tissue antigens
Hypertensive urgency
A situation in which blood pressure is severely elevated but there are no symptoms
Older adults with type 2 diabetes are 2-6 times more likely to have...
A stroke
What is aldosterone?
A vasoconstrictor that assists with volume retention
Embryonic stage is during which weeks?
3-8 weeks after fertilization
Normal potassium
3.5-5.0
Potassium (K+) normal range
3.5-5.0 mEq/L (mmol/L)
How many liters does plasma volume make up?
3.5-6 liters
Moderate hypothermia range
30-34°C (86-93°F)
High flow nasal cannula flow rate
30-60 L *combination of heat and humidity minimizes damage to mucous membranes
Mild hypothermia range
34-36°C (93.2-96.8°F)
Fertility begins to decline at what age?
35-40
Normal ABG paCO2
35-45
The average core temperature (normothermia) is...
36.2-37.6°C (97-100°F)
Normothermia (normal body temperature) range
36.2°C-37.6°C (97°F-100°F)
Normal hematocrit range (female)
37-47%
Neutrophils normal range
40-60%
Simple face mask FIO2
40-60%
What is the minimum amount of urine output per day needed to excrete waste products?
400-600 ml
Fever not harmful until...
41°C (105.9°F)
Normal hematocrit range (male)
42-52%
What age should colon cancer screening begin?
45
Carbohydrate intake should be __%-__% of daily diet
45%-65%
Average age for menopause
45-50
Normal cells contain _____ pairs of chromosomes
46
Simple face mask flow rate
5 L minimum (up to 10 L)
WBC normal range
5,000-10,000
Prediabetes AIC range
5.7%-6.4%
Chronic myeloid leukemia (CML) AND chronic lymphocytic leukemia (CLL) occurs most often after age...
50
Child/adolescents have ___% total body water
50%
How much does renal blood flow increase during pregnancy?
50%
How many ml of fluid loss are considered insensible (unmeasurable)?
500-1000ml
This part of the body produces osteocalcin
Bones
Hypovolemic shock is
A dangerous condition that happens when you suddenly lose a lot of blood or fluids from your body (the heart can't provide the body with enough blood and oxygen it needs to function
When the thermoreceptors signal a lowering of body temperature, the hypothalamus initiates...
A series of heat-producing and heat-conserving mechanisms through endocrine and sympathetic nervous system connections
Hypertensive emergency
A situation in which blood pressure is severely elevated and there is symptoms
Significant changes in hormone levels in pregnancy occur within which gland?
Adrenal gland
Vasopressin or antidiuretic hormone is known as...
ADH
"Lub"/S1 is the sound of
AV (atrial/ventricular) nodes closing (tricuspid/mitral valves)
Neoplasia
Abnormal and progressive multiplication of cells, leading to the formation of a neoplasm
Autoimmune hemolytic anemia
Abnormal immune function in which a person's immune reactive cells fail to recognize her or her own red blood cells and as a result, destroys them
Hyperthermia value
Above 37.6°C (100°F)
Hyperpyrexia value
Above 41.5°C (106°F)
Symptoms of COPD are ____ early in disease
Absent or mild
Movement of fluids and electrolytes within the blood stream is called what?
Absorption
Rewarm trunk before extremities to prevent hypotension from vasodilation is called...
Active external rewarming
Genotype (definition)
Actual alleles for a certain trait (not just what can be observed) *Dominant alleles express trait even if only one copy and recessive alleles can only express themselves if there are two copies (one from each parent)
Most common types of leukemia in children
Acute lymphocytic leukemia (ALL)
Most common types of leukemia in adults
Acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL)
Acuity of leukemia is classified as...
Acute vs chronic
Calcium absorption in the duodenum is dependent on...
Adequate availability of vitamin D
Decreased vaginal lubrication and decreased desire are side effects of which medication?
Antihistamines
Treatment for febrile seizure
Antipyretic
What drug is given to reduce atherosclerosis?
Aspirin
Most common childhood illness is...
Asthma
Do NOT shock if patient is in...
Asystole (give meds and treat underlying cause)
How often should blood glucose be monitored per the "sick day rules"?
At least 4 times a day
Quivering of EKG waves are called
Atrial fibrillation
Human chorionic somatomammotropin (hCS) increases what?
Availability of glucose for the fetus
What does hemoglobin A1C test for?
Average blood glucose over 2-3 months
Which contraceptives have the advantage of providing SOME protection against STDs
Cervical cap
Altered mental status and anxiety occurs in FVD or FVE?
BOTH FVD & FVE
Syphilis and gonorrhea are caused by...
Bacteria
Shivering increases what?
Basal metabolic rate (increases heat)
Sexual identity
Being sexually attracted/attractive to others (heterosexual, lesbian, gay, bisexual, transgender, queer, questioning)
Hypothermia value
Below 36.2°C (97°F)
These cells retain most of their shape and function, but undergo excessive growth (replicate)
Benign cells
What is administered to reduce shivering while in induced hypothermia?
Benzodiazepines
These medications end in "-LOL
Beta adrenergic blockers
Decreased desire is a side effect of which medication?
Betablockers
At what age do women have the option to start screening with a mammogram every year?
Between 40 and 44
At what age should a women get a mammogram every year?
Between 45 and 54
HCO3 is...
Bicarbonate
The only definitive test for breast cancer
Biopsy with pathology
An individual attracted to both females and males
Bisexual
Decreased platelets (thrombocytopenia) may result in what?
Bleeding
Low platelets lead to what risk?
Bleeding
Increased WBCs (leukocytosis) may result in what?
Blood cancer/bone marrow issues
Extreme cases of hypothermia (rewarming)
Blood rewarmed outside body (hemodialysis)
If an infant becomes jittery or lethargic, check...
Blood sugar because nonshivering thermogenesis may cause hypoglycemia
Which laboratory result will be important for the nurse to review when a client is admitted to the hospital with a long history of uncontrolled hypertension?
Blood urea nitrogen (BUN)
Hyperthermia (definition)
Body temperature >37.6°C (100°F) with an UNCHANGED hypothalamic set point
Calcium is primarily stored in the...
Bone
A state of estrogen deficit in menopause can lead to...
Bone loss (osteoporosis)
Mucolytic action
Breaks down thick mucus in lower lung fields
Hormonal therapy (HT) increases the risk of which condition in postmenopausal women?
Breast cancer
What type of medication is LABAs?
Bronchodilator
What type of medication is SABAs?
Bronchodilator
What type of medication is Xanthines?
Bronchodilator
What type of medication is anti-cholinergic?
Bronchodilator
When should a baby become active?
By 24 weeks
Which contraceptives have the advantage of requiring less spermicide
Cervical cap
If you suspect infection, what diagnostic test would you prepare for?
CBC
Asthma is often comorbid with...
COPD
The thyroid gland secretes _____, when there is excess calcium in the blood
Calcitonin
Absorption of ____ requires vitamin D
Calcium
These medications end in "-PINE"
Calcium channel blockers
Malignant (definition)
Cancerous
If hypoglycemic patient can swallow, what treatment would they receive?
Carbohydrates
Oral contraceptives put many women at increased risk for what?
Cardiac issues and stroke
Nursing considerations for hypermagnesemia
Cardiac monitoring (low BP and bradycardia)
What is MOST important for the nurse to monitor when administering IV fluids to a client with hypothermia?
Cardiac rhythm
All daughters of a man affected by an X linked disorder (hemophilia) will automatically be
Carriers
Adrenal medulla produces...
Catecholamines (epinephrine and norepinephrine)
Malignant neoplasm
Cells that have abnormal growth patterns, multiple abnormal functions and the ability to disseminate (spread) to distant sites
Which contraceptives have the advantage of being less noticeable than a diaphragm
Cervical cap
Which contraceptives have the advantage of being smaller than a diaphragm and may fit women who cannot wear a diaphragm?
Cervical cap
Which contraceptives have the advantage of can remain in place for 48 hours
Cervical cap
Which contraceptives have the advantage of no pressure against the bladder
Cervical cap
Why/how does diabetes cause sexual dysfunction?
Damage to nerve tissue and vascular tissue
Medication to treat malignant hyperthermia
Dantrolene
Rise in blood glucose between 4am and 8am not in response to hypoglycemia is defined as
Dawn phenomenon
Blisters of frostbite may require...
Debridement
Isotonic FVD causes body temperature to increase or decrease?
Decrease
Biguanides action
Decrease liver glucose production, which leads to a decreased fasting blood glucose and increased insulin receptor sensitivity
-PENIA
Decreased
-Blood vessels constrict (heat is trapped in deeper tissues) -Sweat glands become less active -Skeletal muscles contract (causing shivering) is indicative of what?
Decreased body temperature
Side effect of betablockers (sexuality)
Decreased desire
What would be the reason for a drop in body temperature in an infant?
Decreased non-shivering thermogenesis
Thiazolidinediones action
Decreases insulin resistance
-Paresthesia -Stiffness is indicative of what?
Deep(er) frostbite
An increased exposure to freezing temperature can cause...
Deeper structures freeze
Is type 1 diabetes mellitus insulin deficient or resistant?
Deficient
Increased blood osmolality is indicative of fluid volume deficit or excess?
Deficit
Osmolality
Degree of concentration; number of electrolytes/solutes in a solution
What is a short-term consequence of hyperglycemia?
Dehydration
Induced hypothermia (definition)
Deliberately lowering body temperature
What is the risk of undergoing radiation?
Developing more malignancy's/cancer
What is the emergent form of hyperglycemia?
Diabetic ketoacidosis
Which contraceptive has the advantage of "can remain in place up to 24 hours"?
Diaphragm
Which contraceptive has the advantage of being able to be inserted several hours before coitus?
Diaphragm
Which contraceptive has the advantage of providing some protection from STDs?
Diaphragm
Which contraceptives have the disadvantage of difficultly inserting or removing for some women?
Diaphragm
Which contraceptives have the disadvantage of requiring education on proper use?
Diaphragm
Manifestations of dehydration are easy or difficult to recognize in older adults?
Difficult
Particles (solutes) spread/move through random motion from an area of higher concentration to an area of lower concentration until equilibrium is reached is defined as what?
Diffusion
What does the pancreas control?
Digestion and insulin
Elevation of legs above the heart in PAD patients is ________
Discouraged (it slows the arterial blood flow to the feet) *Remember DANGLE NOT elevate
Diabetic nephropathy in relation to diabetes (microvascular)
Disease of kidneys characterized by presence of albumin in urine, hypertension, edema, progressive renal insufficiency
Diabetic neuropathy in relation to diabetes (microvascular)
Disorder in peripheral nerves and autonomic nervous system
Sex-linked dominant
Disorders present on sex chromosome
Convection (definition)
Dispersion of heat by air currents (cold water, fan)
Acute peripheral arterial occlusion (definition)
Embolus that travels and lodges itself in the artery, occluding blood flow *Most common cause of peripheral occlusion *Most common in lower extremities **Put Nothing on the legs
Which contraceptives have the advantage of available over the counter to patients 17 years and older?
Emergency contraception (plan B & copper IUD)
Movement of fluid and electrolytes between the various body fluid compartments (intracellular, extracellular) is called what?
Distribution
Decreased vaginal lubrication, decreased desire, and erectile dysfunction are side effects of which medication?
Diuretics
First meds for hypertension
Diuretics (ACE/ARBs)
Considerations of aspirin
Do NOT use for children (risk for Reye syndrome), only adults
Considerations for corticosteroids
Do not stop abruptly
Descending colostomy
Done for left sided tumors
Sigmoid colostomy
Done for rectal tumors
Ascending colostomy
Done for right sided tumors
Trisomy example
Down syndrome (trisomy 21)
What diagnostic test would you prepare for to assess a possible cardiac injury?
EKG and cardiac enzymes
Pre-menopause
Early stage of climacteric before menstruation ceases, but the body is experiencing symptoms (irregular periods)
Which clinical manifestation would the nurse expect to find in a client with a new diagnosis of acute lymphocytic leukemia (ALL)?
Ecchymosis
Which laboratory result requires attention for tumor lysis syndrome (TLS)
Electrolyte levels
Which action would the nurse take when a client with chronic venous insufficiency has ankle edema?
Elevate the legs
Fever (definition)
Elevation in body temperature due to a CHANGE in the hypothalamic set point *Typically occurs with an illness
Anxiety, fatigue, depression, negative body image, privacy, and trust all can cause what type of erectile dysfunction?
Episodic
Psychogenic erectile dysfunction
Episodic
Erythropoietin example
Epoetin Alfa
Electrolytes are normally gained and lost in relatively ______ amounts
Equal *but imbalances can occur
Oral-phosphodiesterase-5 inhibitors (PDE5) (can lower blood pressure) (result in smooth muscle relaxation; improving blood flow) are used for what?
Erectile dysfunction
Penile injection is used to treat what?
Erectile dysfunction
Urethral suppositories are used to treat what?
Erectile dysfunction
Red blood cells examples
Erythrocytes
Increased RBCs
Erythrocytosis/polycythemia
Causes uterus to increase in size, weight is an effect of which female hormone?
Estrogen
Nasal congestion (pregnancy)
Estrogen causes increase blood flow to mucous membranes
Normal glucose is defined as
Euglycemia
Continuous evaporation of moisture from respiratory tract, mucosa of mouth, skin (sweating, rapid breathing)
Evaporation
How often are colonoscopy screenings?
Every 10 years
How often should tetanus vaccines be given?
Every 10 years
How often are CT colonography (virtual colonoscopy) screenings
Every 5 years
How often are flexible sigmoidoscopy screenings?
Every 5 years
How often is a human papillomavirus test performed?
Every 5 years
Decreased blood osmolality is indicative of fluid volume deficit or excess?
Excess
Primary prevention (reproduction)
Health education -Safe sex -Contraception -Avoidance of smoking, alcohol, drug use -Nutrition (water (8-10 cups), Iron, & folic acid: all woman of reproductive age should get 400 μg if folic acid every day in addition to consuming foods with folates (beets, nuts, seeds, avocados) to prevent neural tube defects) -Exercise
Magnesium absorption relies on...
Healthy intestinal epithelium in the terminal section of the ileum
Selective Beta-adrenergic blockers focus on what?
Heart
This part of the body produces arterial natriuretic peptide and brain natriuretic peptide (ANP and BNP)
Heart
Non-selective Beta-adrenergic blockers focus on what?
Heart & lungs
If heat exhaustion is not treated appropriately it can turn into...
Heat stroke
Set point does NOT change with what?
Heat stroke & heat exhaustion
Lymphocytes action
Help fight viruses and make antibodies
Red blood cells (erythrocytes) action
Helps in O2 and CO2 exchange
Platelets (thrombocytes) action
Helps in blood clotting
After cellular metabolism, carbon dioxide is the byproduct and gets carried by...
Hemoglobin to the lungs where it is exhaled
Warfarin is the PO version of
Heparin
Secondary hypertension (definition)
High blood pressure caused by the effects of another disease or drugs
Heat stroke (definition)
High environmental temperature/high humidity -> dysfunction in brain's thermoregulatory center; body loses ability to cool through sweat *medical emergency!
Nursing considerations for Xanthines
High levels of toxicity
Which contraceptive has an advantage of 3-year protection?
Hormone implant
Which contraceptive has an advantage of being safe during lactation?
Hormone implant
Which contraceptive has an advantage where body weight has no effect?
Hormone implant
Which contraceptives have the disadvantage of being a minor surgical procedure to insert and remove?
Hormone implant
Which contraceptives have the disadvantage of the major side effect being irregular bleeding?
Hormone implant
What diagnostic test would you prepare for with head traumas or tumors?
Imaging studies
Lymphocytic leukemia (cell type)
Immature lymphocytes infiltrate spleen, lymph nodes, CNS *B cells and T cells
Graft-versus-host disease (GVHD)
Immune cells identify the patient's body tissue as foreign and begin to attack them
Dehydration causes body temperature to increase or decrease?
Increase
Antihypoglycemic action
Increase blood glucose levels and relaxes GI smooth muscles
Primary role of T3 and T4 in adults
Increase metabolism
-TOSIS
Increased
Blood vessels dilate (giving flushed appearance) -Sweat glands become more active are indicative of what?
Increased body temperature
Erythropoietin action
Increased bone marrow erythrocyte production
One of the first signs that a client with malignant hyperthermia would present with
Increased expired carbon dioxide
Compartment syndrome definition
Increased pressure inside a muscle compartment causes ischemia to that muscle
Adverse effects of menopause hormone therapy (MHT)
Increased risk for breast and uterine cancers
Decreased ALL WBCs (leukopenia) may result in what?
Infection
Decreased neutrophils (neutropenia) may result in what?
Infection
Relaxin does what throughout pregnancy?
Inhibits uterine activity and softens connective tissue in the cervix, and lengthens public ligaments
What is the hormone that lowers glucose?
Insulin
This part of the body produces erythropoietin and renin
Kidneys
COPD patients need _____ oxygen levels
LOW (it is needed, but in low levels) (low oxygen is their normal drive to breathe, hence why administering high levels of oxygen can actually cause harm) *EXCEPTION: severe respiratory distress/failure (higher levels of oxygen are acceptable)
Reason for brownish discoloration of the skin on the legs with venous insufficiency
Leakage of red blood cells (RBCs) through the vein wall
Females attracted to females
Lesbian
Severe hypothermia range
Less than 30°C (86°F)
Acute leukemia is a result of...
Leukocyte development being halted at the blast phase (immature cell phase) *can progress rapidly with death occurring within weeks to months without aggressive treatment
Increased WBCs
Leukocytosis
Decreased ALL WBCs
Leukopenia
These medications end in "-lukast"
Leukotriene modifiers
HELLP syndrome (definition)
Life threatening pregnant complication usually considered to be a variant of preeclampsia (hypertension) involving the liver *occurs in 3rd trimester or after 48 hours of delivery (up to 72 hours)
This part of the body produces angiotensinogen, insulin-like growth factor-1, and thrombopoietin
Liver
Side effects of acetaminophen
Liver damage *liver toxic
Heat exhaustion (definition)
Loss of body fluid volume caused by excessive sweating without adequate replacements *Beyond body's ability to compensate
What kind of diet should patients with fluid volume excess be on?
Low sodium diet (salt substitutes are okay in small amounts)
What electrolyte assists with skeletal muscle contraction, carbohydrate metabolism, generation of energy stores, vitamin activation and blood coagulation?
Magnesium
Anatomy of interior lungs
Main stem bronchi leads to bronchi which leads to bronchioles which lead to alveolar ducts and alveoli
Mechanism of action for Leukotriene modifiers
Maintenance med to prevent asthma attacks
Replication
Making a copy of a cell
Develops through the fertilization of the ovum by a Y barring sperm
Male fertilization
Alpha, beta, and delta cells are primarily produced in what gland?
Pancreas
This gland is both an endocrine gland and an exocrine gland
Pancreas
Alterations in maternal blood glucose levels and fluctuations in insulin production during pregnancy occur within which gland/organ?
Pancreas *increased glucose levels trigger pancreas to release insulin
Decreased RBC and WBC
Pancytopenia
_____ secretes PTH if there is an increase of blood calcium
Parathyroid
Tumor lysis syndrome
Part of the tumor breaks off and begins to circulate in the blood stream
After rewarming a frostbite patient, you want to do what?
Patient on bedrest with affected parts elevated
Autologous BMT
Patient's own bone marrow taken during period of remission
Which medication would be prescribed for pregnant patients diagnosed with syphilis
Penicillin G
Antiplatelets are given for what type of patients?
Peripheral arterial disease
Anticoagulants are given for what type of patients?
Peripheral vascular disease
_____ is having brown eyes, Bb or BB is the _____
Phenotype, genotype
Thiazolidinediones examples
Pioglitazone
Hormones secreted by the hypothalamus work primarily on the _____
Pituitary
Prolactin prepares breasts for milk production through which gland?
Pituitary gland
Secretion of TH initiated by release of TSH from ____
Pituitary gland
______ is the master gland and controls energy, metabolism, and growth
Pituitary gland
Aspirin and ibuprofen given to a child who is thrombocytopenic can cause...
Platelet dysfunction
Colon cancer stems from...
Polyps
Decrease in fetal heartrate during a contraction is a _____ CST
Positive, non-reassuring (infant does not have adequate oxygen reserves)
______ does not produce hormones, but provides storage for ADH and oxytocin
Posterior pituitary
What electrolyte is highest in meat, fish, vegetables and fruits?
Potassium
Goal of aplastic anemia is
Prevent hemorrhage and infection
Antitussive action
Prevents cough
Mechanism of action for anticoagulants
Prevents growth/formation of clots
What does folic acid do for pregnancy?
Prevents neural tube defects
Mechanism of action for antiplatelets
Prevents platelets from sticking together
Condom use is what type of prevention (sexuality)?
Primary
HPV vaccine is what type of prevention (sexuality)?
Primary
Patient education is what type of prevention (sexuality)?
Primary
Safe-sex practices is what type of prevention (sexuality)?
Primary
Proliferation
Production of new cells through growth and division *(mitosis-cells divide to develop normal tissues or to replace lost or damaged normal tissues) (meiosis-sex cell reproduction)
New cells are formed through a process of cell division referred to as...
Prolifertation
Sulfonylureas action
Promotes the release of insulin from the pancreas by stimulating beta cells
If expecting mother is Rh negative and baby is positive, the mother may receive
Rh immunoglobulin around 28th week of pregnancy to prevent sensitization for the rest of pregnancy *If the baby is born and has Rh positive blood, then the mother is given another dose of Rh immunoglobulin postpartum
How would you diagnose and evaluate the extent and progression of COPD?
Pulmonary function test (PFT)
Umbrella term for LGBTQ+
Queer
Which heat-loss mechanism would the nurse minimize by swaddling a newborn infant with a blanket?
Radiation
Is hypoglycemia a slow or rapid onset?
Rapid
Febrile seizure is a result of...
Rapid temperature rise to above 39°C (102.2°F) with acute illness
Fanconi anemia
Rare genetic form of aplastic anemia caused by defects in DNA repair
8-10 score on biophysical is_____
Reassuring
Rubor
Redness of skin (from inflammation)
This is the only type of insulin that can be administered via IV (everything else is SQ)
Regular insulin
This type of insulin is short acting, clear, with a <30 minute onset
Regular insulin
Short acting insulin examples
Regular insulin (humulin-R)
Decongestant action
Relieves nasal and sinus congestion
Radical mastectomy
Removal of the entire affected breast, the underlying chest muscles, and the lymph nodes under the arms
Modified radical mastectomy
Removes breast tissue, lymph nodes, and sometimes part of the underling chest wall muscle
What diagnostic test would you prepare for if patient has severe hyperthermia and dehydration?
Renal functions
Renin is apart of what system?
Renin-angiotensin-aldosterone system (vasoconstriction)
Is type 2 diabetes mellitus insulin deficient or resistant?
Resistant
Initial intervention for a child who presents to the ED with sustained frostbite of the toes
Rewarm the toes by placing the feet in warm water
Active external rewarming
Rewarm trunk before extremities to prevent hypotension from vasodilation (warming from outside)
Side effects of anticoagulants
Risk for bleeding/bruising
Heritability (definition)
Risk for developing a disorder can be transmitted to one's children in a recognizable pattern
What is the pacemaker of the heart?
SA node
What test detects between B12 deficiency anemia and pernicious anemia?
Schilling test
At what stage is an individual with syphilis most infectious?
Secondary
Which stage of syphilis would the nurse associate with a sexually active client who reports sore throat, generalized rash, and history of a healed chancre (lesion) from 3 months ago?
Secondary
Nursing considerations for hypocalcemia
Seizure precautions
Nursing considerations for hypernatremia
Seizure precautions (if severe)
Weight loss of >10% is ____ FVD
Severe
Which complication will occur as the result of administering sildenafil to a client who takes isosorbide dinitrate?
Severe hypotension
Less than 30°C (86°F) is indicative of what?
Severe hypothermia
Which condition would the nurse avoid applying external rewarming devices due to rapid vasodilation?
Severe hypothermia
What does a pink triangle in a health care facility signify?
The health care facility welcomes LGBTQ+ clients
If egg is fertilized, it implants in the lining of the uterus and produces
The hormones that are necessary to maintain corpus luteum (human chorionic gonadotropin (HCG)) (increased progesterone: needed to maintain thickening of the lining of uterus)
Aldosterone causes
The kidneys to retain sodium and water (increases blood pressure and volume)
The greatest amount of heat is produced by...
The muscles and metabolic activity in the liver
Chronic obstructive pulmonary disease (COPD) is...
a collection of lower airway disorders that interfere with airflow and gas exchange
Tension pneumothorax definition
a type of pneumothorax in which the severity of the collapsed lung begins to put pressure on the heart *emergent/severe-> chest tube
Pulses in peripheral arterial disease are...
absent/decreased
A pH lower than 7.35 indicates
acidosis
Hypertension increases...
afterload (workload of the heart)
A pH greater than 7.45 indicates
alkalosis
Capnography (ETCO2) evaluates...
alveolar ventilation
Atelectasis is the collapse of...
alveoli
Stroke volume (definition)
amount of blood ejected from each ventricle during contraction
Perfusion
arterial blood flow through tissues, and blood pumped by the heart
AV valves are between the
atria and ventricles
P wave indicates
atrial contraction
Platelets correlate to
blood clotting
Hemothorax definition
blood in the pleural cavity
Vascular system returns
blood to the heart for recirculation
Vascular system provides a route for
blood to travel from the heart to nourish the various tissues of the body
Alveoli are surrounded by...
capillaries
Blood clots, plaque buildup, and emphysemic alveoli interfere with...
capillary blood flow
Many patients with emphysema also have...
chronic bronchitis
#1 cause of COPD
cigarette smoke
What is a priority and safety symptom of anemia?
dyspnea without exertion, but with severe confusion, weakness, and fatigue
Process of COPD
damage to airway passages -> increased mucus production -> arrest in cilia action
Hypoxemia
decreased oxygenation in the blood that can lead to hypoxia if left untreated
Hypoxia
decreased tissue oxygenation
Lung sounds indicative of emphysema
diminished lung sounds
PaO2 is...
dissolved oxygen in blood
When the brain causes seizing in preeclampsia, it can progress to...
eclampsia
Stage 1 and 2 hypertension are further classified as
essential or secondary
Basic progression of COPD
excessive fluid accumulates in lung mucosal cells -> edema -> narrowing of airway passages-> airflow limitation, air trapping, hyperinflation of lungs -> bronchitis
If there is an increase in the pH level (alkalotic), the kidneys will...
excrete bicarbonate
Symptoms of anemia
fatigue (first sign)
Afterload (definition)
force the ventricles must exert to open the semilunar valves
ABGs evaluate...
gas exchange and acid-base balance
Granulocyte (WBC) transfusion
given (rarely) to neutropenic clients
Massive transfusion protocol
given when H&H levels are low
Greater preload equals
greater the stretch of the myocardium and stronger contraction
Oxygen is carried by the ____ to the cells
hemoglobin
Heparin risk factors
high risk bleeding
pH is...
hydrogen ion concentration
ETCO2 levels below 35 mmHg indicate
impaired perfusion
ETCO2 levels above 45 mmHg indicate
inadequate ventilation
Stomatitis
inflammation/sores in the mouth
Patients use ___ for quick relief of acute symptoms
inhaled short-acting beta-agonist (SABA) *long term control strategies may need modification if SABA is needed >2x/week
Onset of aplastic anemia is usually...
insidious, may be sudden
Ischemia
insufficient flow of oxygenated blood to tissues that may result in hypoxemia, subsequent cell injury or death
What is the most common type of anemia?
iron deficiency anemia
The most common cause of secondary hypertension is...
kidney disease
Magnesium sulfate is excreted in the
kidneys
Right sided heart failure puts stress and back up fluid in the
legs
Nail clubbing indicates...
long term hypoxia
Blood loss anemia definition
loss of RBCs, other blood components
The basic pathophysiology of anemia involves a reduction in
the total number of circulating erythrocytes
The aortic valve takes the blood...
through the aortic valve and to the aorta
Aspirin toxicity symptom
tinnitus
Left sided heart failure puts stress and back-up fluid into the
lungs
Anticonvulsant example
magnesium sulfate
What is used to prevent seizures in preeclampsia?
magnesium sulfate
pH↓ HCO3↓
metabolic acidosis
pH↑ HCO3↑
metabolic alkalosis
Pulses in peripheral venous disease are...
normal
Sinus rhythm
normal heart rhythm
Arterial system delivers
oxygen and nutrients to various body tissues
Greatest benefit in severe hypoxemia is when...
oxygen is used continuously
Acute COPD exacerbation may require...
oxygenation and inspiratory positive pressure assistance with face mask or intubation and mechanical ventilation
If you elevate legs, the patient is
pale
PaCO2 is...
partial pressure of carbon dioxide
If PTT is too high
patients DIE (bleed out)
Failure to absorb B12 is called
pernicious anemia *lack of intrinsic factor that binds B12
The lungs are located in the...
pleural cavity
Anticonvulsant action
prevention of seizures
Antidote for heparin
protamine sulfate
Lungs deliver oxygen to the...
pulmonary capillaries
Sinus tachycardia
regular rhythm, BUT >100 bpm
Purpose of oxygen therapy
relieves hypoxemia and hypoxia
COPD results from...
repeated exposure to respiratory irritants that begin to damage structure of respiratory system
Plasma transfusion
replaces blood volume and clotting factors
RBC transfusion
replaces cells lost from trauma or surgery *only provides red blood cells
Systemic vascular resistance
resistance to the ejected blood created by the diameter of blood vessels receiving the blood
pH↓ PCO2↑
respiratory acidosis
pH↑ PCO2↓
respiratory alkalosis
If there is a decrease in the pH level (acidotic), the kidneys will...
retain bicarbonate
If you dangle the legs, the patient is
rubor
What assists in determining etiology of COPD?
serum a1-antitrypsin levels
Lung transplants can be
single or bilateral *good survival rates
With mild exacerbation of COPD instruct patient to...
sit up over the bedside table to breathe
What drug lowers cholesterol and acts as an antiplatelet?
statin
Contractility (definition)
strength of myocardial contraction
Surgical intervention for pernicious anemia
surgery to assess for causative disorder
Pneumothorax is the collapse of...
the entire lung
Ventilation and perfusion scanning determine what?
the extent of V-Q mismatch (i.e., the extent to which the lung tissue is ventilated but not perfused [dead space] or perfused but inadequately ventilated [physiologic shunting])
The pulmonic valve goes into
the pulmonary artery
Fast heartbeat is due to
the rapid firing of the sinoatrial (SA) node *atrial and ventricular rhythm are regular
Anoxia
total lack of oxygen in body tissues
VQ ratio
ventilation perfusion ratio
QRS wave indicates
ventricular contraction
Vitamin B12 deficiency anemia vs. pernicious anemia
vitamin B12 (inadequate intake of B12), pernicious anemia (adequate intake of B12, BUT gut lacks appropriate intrinsic factor to absorb B12)
Antidote for warfarin
vitamin K
Diastole
when the ventricles are filling/relaxed
Trachea is also known as
windpipe
Cardiac output (definition)
· = the amount of blood pumped by the heart each minute (SV (stroke volume) x HR (heart rate) = CO)
Should fetal heart rate decrease, stay the same, or increase with fetal movement?
· Increase
Erythropoietin is a medication that can be given in order to...
·-Stimulate RBC production -must have adequate iron level or may need to receive both
