Kaplan Nclex

lifetime prevalence

The percentage of people in a certain population who will have a given disorder at any point in their lives.

point prevalence

The percentage of people in a given population who have a given disorder at any particular point in time.

concordance rate

The probability that a person with a particular familial relationship to a patient (e.g., an identical twin) has the same disorder as the patient.

assessment

The set of procedures for gathering information about an individual's psychological state, sometimes leading to a diagnosis.

psychopathology

The study of mental disorders, or a term for the mental disorder itself.

comorbidity

The tendency for different mental disorders to occur together in the same person.

Cannabis Derivative Abuse Implementation

There really is no implementation - most effects disappear in 5-8- hours

Antipsychotic Agents Med Names

Thorazine-low, Trilafon-medium, Haldol-high

Antiemetics: Med Names

Tigan, Compazine, Reglan, Antivert, Dramine

Amyotrophic Lateral Sclerosis (ALS):S/Sx

Tongue fatigue, atrophy with fasciculation (brief muscle twitching) Nasal quality to speech, dysarthria (difficulty saying words), Dysphagia, aspiration Progressive muscular wasting, atrophy, spasticity, weakness -usually begins in upper extremities, distal portion affected first, fasciculations. Emotional lability (b/c death is outcome), cognitive dysfunction Respiratory insufficiency (usual cause of death) No alteration in autonomic, sensory, or mental function.

Interventions for Pressure Ulcers

Turn frequently Ambulate Good skin care Balanced diet with protein, vitamins, minerals

Antipyretic Med Name

Tylenol

Which type of DM is ketosis prone?

Type 1

which type of DM requires insulin injection

Type 1

Antidiabetic Agents: Uses

Type 2 diabetes

Chrons dx vs ulcerative colitis: resmissions and relapses?

UC Chrons - prolonged

causes for pyelonephritis

UTI, pregnancy, tumor, obstruction

Furadantin (nitrofurantoin) Uses

UTIs

Pyridium Uses

UTIs

Chrons dx vs ulcerative colitis: 10-20 liquid stools qday

Ulceratie Colitis 5-6 unformed stools chrons

Chrons dx vs ulcerative colitis: common rectal bleed

Ulcerative Colitis occasional in chrons

Chrons dx vs ulcerative colitis: age 30-50

Ulcerative colitis Chrons: 20-30, and 50-80

Insulin: Slow Acting Names

Ultralente Humulin U

Signs & Symptoms of Compartment Syndrome

Unrelenting pain out of proportion to injury and unrelieved by pain meds Decreased pulse strength Numbness & tingling of extremity Possible cyanosis and pale cool extremity

Antidiarrheals: Nursing Considerations

Use before chemo When used with viral infections may cause Rye's syndrome

Antineoplastic: Vinca Alkaloids Med Names

Velban (vinblastine), Oncovin (vincristine)

Anti Impotence (Erectile Dysfunction) Med Names

Viagra, Levitra, Cialis

Antibiotics: Tetracyclines Med Names

Vibramycin, Panmycin

After surgical repair for ulcers, what medication is required for life?

Vitamin B12 & iron

Cerebral Palsy: Analysis/Tx

Voluntary muscles poorly controlled due to brain damage. Etiology: unclear Predisposition:prematurity, existing prenatal brain abnormalities, trauma, axnoia, or infection at time of birth. Tx: Ambulation devices, surgical lengthening of heel cord to promote stability and function. Assist with feeding, place food at back of mouth or on either side of tongue toward cheek, apply slight downward pressure with the spoon. NEVER TILT HEAD BACKWARD WHEN FEEDING, High calorie diet. Medications:muscle relaxants, tranquilizers, anticonvulsants, baclofen (lioresal) intrathecal pump.

What lab may be elevated with a pt with suspect appendictis?

WBC >15,000-20,000

Vitamin K

Warfarin

Antidepressants: Heterocyclics Med Names

Wellbutrin, Desyrel

Antidepressants: Heterocyclics Side Effects

Wellbutrin: agitation Desyrel: sedation

Fractures

What is it? A break in continuity of bone Types of fractures: --Complete: Break across entire cross-section of bone --Incomplete: Break through portion of bone --Closed: No external communication --Open: Extends through skin S/S: Swelling, pallor, ecchymosis, loss of sensation, deformity, pain & acute tenderness, muscle spasms, loss of function, abnormal mobility, crepitus, shortening of affected limb, decreased or absent distal pulses, extremity is colder Treatment: --Provide emergency care --Splinting & Surgery --Traction --Casting

Strains

What is it? A muscle and/or tendon pull or tear S/S: Pain & Swelling Treatment: --Rest and elevation of affected part --Intermittent ice compresses for 24 hrs, followed by heat application --Apply elastic pressure bandage --Minimize use

Sprains

What is it? A torn or stretched ligament S/S: Pain & Swelling Treatment: --Rest and elevation of affected part --Intermittent ice compresses for 24 hrs, followed by heat application --Apply elastic pressure bandage --Minimize use

Joint dislocations

What is it? Displacement of joint bones so their articulating surfaces lose all contact. S/S: Pain & Deformity Treatment: --Considered an orthopedic emergency --Immobilization and reduction (ex: the dislocated bone is brought back to its normal position, usually under anesthesia) --Bandages and splints are used to keep affected part immobile until healing occurs.

Contusions

What is it? Injury of soft tissue S/S: (Ecchymosis) bluish, purple bruise, (Hematoma) swelling filled w/ blood Treatment: --Cold application for 24 hrs followed by moist heat. --Apply elastic bandage

Post-amputation Delayed Prosthesis Fitting

What is it? It is when the residual limb is covered with a dressing with figure-eight wrapping & elastic bandage or residual limb sock Treatment: Residual limb care --If penrose drain is inserted; reapply bandages Q 4-6 hrs --Observe dressings for signs of excessive bleeding; keep large tourniquet on hand to apply around residual limb in event of hemorrhage --Dressings changed daily until sutures are removed --Wrap with elastic bandage to shape, reduce edema, and keep dressing in place --Figure-eight- it prevents restriction of blood flow Positioning- If ordered, elevate residual limb by elevating foot of bed Turning- On 1st post-op day,position pt to prone position for short time, then 30 min 3x's/daily. Pt can role side-to-side Exercises- Start 1st or 2nd post-op day; Active ROM, strengthening exercises for upper extremities, hyperextension of residual limb Ambulation- 1st or 2nd post-op day, dangle & transfer to wheelchair; crutch walk as soon as pt feels strong enough

Immediate Prosthesis Fitting

What is it? Residual limb is covered with a dressing and a rigid plastic dressing; No penrose drain; Rigid dressing helps prevent bleeding Treatment: Residual limb care --Observe dressing for signs of oozing --If blood stain appears, mark area & observe Q 10 min for increase --Report excessive oozing --Provide cast care, Guard against cast slipping off Positioning- Elevation of residual limb for 24 hrs Turning- Turn pt to prone position 30 min 3x's/day Exercise- Early ambulation prevents immobilization disabilities Ambulation- 1st day- dangle & assist pt to ambulate w/ walker; increase length of ambulation each day; In PT pts use parallel bars, then crutches, then cane

Antivirals Med Names

Zovirax, AZT, Videx, Famvir, Cytovene

Alcohol is

a CNS depressant

Meningocele

a congenital anomaly of the central nervous system in which a sac protruding from the brain or the spinal meninges contains cerebrospinal fluid (but no nerve tissue); covered with a think atrophic, bluish, ulcerated skin.

Myelomeningocele

a congenital defect of the central nervous system in which a sac containing part of the spinal cord and its meninges protrude through a gap in the vertebral column (spinal fluid and spinal cord elements- no lamina in spinal cord)

nevus flammeus

a port wine stain on face or neck that is permanent birthmark of newborn

Korsakoff's Psychosis

a secondary dimentia caused by the Thiamine deficiency associated with prolong and heavy alcohol injestion

A

a sore that does not heal

Etiology 2- defect in cellular differintiation

a. oncogenes take over the normal b. cells regain fetal appearance and function c. some hormones some proteins

what are s/s of peritonitis?

ab pain - severe ridigitdy, distension increased temp leukocytosis

siezure

abnormal discharge from brain cells, altered motor, sensory, autonomic or psychic activity

Laxatives/Stool Softeners Action

absorb water increasing bulk, lubricate surface of stool, stimulate peristalsis

Mucomyst/ acetylcysteine

acetaminophen

Narcotics Action

acts on CNS receptor cells

Antipsychotic Agents Uses

acute and chronic psychoses

Antibiotics: Macrolide Uses

acute infections, acne, URI, prophylaxis before dental procedures if allergic to PCN

Antineoplastic: Antimetabolites Uses

acute lymphatic leukemia, cancer of colon, breast, pancreas

Thrombolytics Uses

acute pulmonary emboli, thrombosis, MI

oliguric phase of decreased output of <400 ml/day, HTN, anemia, PE, CHF, confusion

acute renal failure

meds for genital herpes

acyclovir, sitz bath

need to add hormones

addisons disease - play on words to remember

Antihypertensives: Alpha 1 Adrenergic Blockers Nursing Considerations

administer first dose bedtime to avoid fainting Monitor BUN, weight and edema Change position slowly

expect resistance

adolescent teaching common behavior

dobutrex and intropin

adrenergic meds to restore blood pressure in shock clients

up and back adult, down and back for child

adult and child ear drops ear positions

compression depth CPR

adults 2cm; children at least 1/2 AP diameter; infants at least 1/4 AP diameter or about 1.5 inches

who is at risk for HHNK?

adults >50yrs old (acute illness, thiazide medications, dialysis)

What is pyloric stensosi casued from in adults/infants

adults: scaring from healing ulcers (PUD) infants: obstruction hypertrophy and hyperplasia of pylorus

downstairs with cane

advance cane & weak leg, then strong leg; memory trick: the good goes up, the bad goes down

Antianxiety Actions

affect neurotransmitters (CNS depressent)

right side, back fowlers, then left side

after a intestinal is in the stomach instruct client to position change this way

specimen on ice, was client on O2 room air

after sample is collected how is it bagged and was client on this med is to be noted

1-7 years

ages for play of imitation

8-12 years

ages of games and hobbies play

0-1 years

ages of play for just holding toys

Antigout Agents: Side Effects

agranulocytosis, GI upset, renal calculi

mixing insulins properly

air into cloudy, air into regular DRAW UP CLEAR FIRST!

TB precautions

airborne precautions

about Bell's palsy

aka facial paralysis, recovery takes 3-5 wks.; inability to close eye, decreased corneal reflex, increased lacrimation, loss of taste, speech difficulty. Analgesics, avoid cold, drafts, isometric exercises for facial muscles (trmt: electrical stimulation, steroids)

Antipsychotic Agents Side Effects

akathisia, dyskinesia, dystonia, parkinson's syndrome, tardive dyskinesias, leukpenia

Antihistamines: Uses

allergic rhinitis, allergic reactions to blood

Alkylating #3 Cytoxan SE's

alppecia, bone marrow depression, hemorragi cystitis, dermatitis, hyperkalemia, hypoglycemia, amenorrhea

Cyctic fibrosis (cause, tx/diet)

alt in fat metabolism cause: absence of pancreatic enzymes leads to malabsoprtion of fat (and fat soluble vitamins) and wt loss (infection & lung dx lead to increase need for calories) tx: pancreatic enzyme replacement (cotazym pancrease) BEFORE or WITH meals HIGH PROTEIN HIGH CALORIE diet

Hepatobiliary dx (cause, tx/diet)

alt in fat metabolism cause: decrease bile leads to fat malabsorption tx: low-fat, HIGH protein diet, increase vitamins

Gout (cause, risk, tx/diet)

alteration in protein metabolism cause: error of purine metabolism risk: joint deteroration tx: low-purine diet (no FISH!)

earliest sign of inc ICP

altered LOC

30 ml of solution(NS)

amount of irrigation solution to put into cathter tube for irrigation

Antibiotics: Penicillins Med Names

amoxicillin, ampicillin, augmentin

Heberden's nodes

an abnormal cartilaginous or bony enlargement of a distal interphalangeal joint (DIP) of a finger, furthest joint. Usually occurring in degenerative diseases of the joints (Osteoarthritis).

Antibiotics: Sulfonamides Actions

anatgonize essential component of folic acid synthesis

assess for chronic renal failure

anemia, acidosis, azotemia(high urea and creatinine), fluid retention, altered urine output

spinal anesthesia (saddle block) for c-section

anesthetic injected into subarachnoid space at L3 to L5

regional lumbar epidural block, may be PCA

anesthetic most popular injected into epidural space between L4 and L5

Antihypertensives: Calcium Channel Blockers Uses

angina, hypertension, interstitial cystitis

Antianginals Uses

angina, peri-operative hypoertension, HF

Sudden onsent, emergency glaucoma?

angle-closure (closed-angle) cause by emotional distrubances, allergy, vasomotor disturbances

SIADH

anorexia, lethargy, HA, change in LOC, decreased deep tendon relfex, tachycardia, decreased urine output

what type of meds are used for glomerulonephritis

antibiotics, corticosteroids, antihypertensives, immunosuppressives

valium, dilantin, pheobarbital

anticonvulsant meds to help decrease ICP

menieres drug therapy

antihistamines (epi, Benadryl); antiemetics (Compazine); antivertigo (Antivert, valium reglan, tigan); diuretics (Dyazide)

actinomycin d considerations

antimetic

Antipyretic Action

antiprostaglandin activity in hypothalamus

meds for rubella german measles

antipyretics, analgesics

Antianxiety Uses

anxiety disorders, manic episodes, panic attacks

stroke s/s

aphasia, hemiplegia, hemianopsia (loss of half of visual field)

apical rate 100 sleep, 120-140 awake, 180 crying

apical heart rate fo newborn

LDH

appears 12-24 hrs; peaks 48-72 hrs; lasts 6-12 days

What referal may you make with a pt with gastritis?

approp agency of ETOH abuse is verified

Cullens sign

around umbilicus

stage 3 lyme disease

arthralgia- inflamed and pain in joints

NSAIDS Uses

arthritis, mild to moderate pain, fever

vaginal dark red bleeding, abdomen pain, tender, tense, fetal distress, contractions

assess abruptio placenta

confusion, disorientation, incontinent, hemiplegia, HA, aphasia, dysphagia, seizure

assess brain attack

mottled skin, cyanosis, metabolic acidosis, hypoglycemia

assess cold stress infant

fatigue, wekaness, dehydrated, hypotension, tan, alopecia, weight loss,

assess for addisons disease

HA, sweating, nasal congestion, goose bumps, bradycardia, HTN

assess for autonomic hyperreflexia

osteoporosis, muscle wasting, HTN, purple skin striations, moon face, truncal obesity, decreased resistance to infection

assess for cushings syndrome

watery discharge, irregular menstrual bleeding, menorrhagia(heavy period)

assess for endometrial cancer (uterus)

K < 3.5mEq/L, weakness, paresthesias, dysrhythmias, increased sensitivity to digitalis

assess for hypokalemia

red inflammed breast, exudate from nipple, fever, leukocytosis,

assess for mastitis

boggy uterus, lochia regresses, excessive bleeding, distened uterus

assess for postpartum hemorrhage

temp >100.4, chills, tachycardia, abd pain, lochia foul, elevated WBC, cultures

assess for postpartum infection

150-160/100-110 bp, 4+ proteinuria, HA, epigastric pain, PE, hyperreflexia

assess for severe preeclampsia

sudden fever, vomitting, diarrhea, drop in systolic BP, rash on palms and soles

assess for toxic shock syndrome

Ca > 5.2 mEq/L, sedative effect on CNS, muscle weakness, lack of coordination, constipation, abd pain, decreased deep tendon reflex, dysrhythmia

assess hypercalcemia

Mg > 2.5 mEq/L, hypotension, depressed cardiac impulse, absent deep tendon relfex, sallow respiration

assess hypermagnesemia

>145 mEq/L, disorientation, delusion, hallucination, thirst, dry, swollen tongue, sticky mucous membranes, hypotension, tachycardia

assess hypernatremia

Ca <4.5 mEq/L, tetany, trousseau's sign, chvosteks sign, seizures, confusion, irritable, paresthesias

assess hypocalcemia

jitters, irregular respirations, cyanosis, weak, high pitched cry,

assess hypoglycemia infant

Mg <1.5 mEq/L, neuromuscular irritability, tremors, seizures, tetany, confusion, dysphagia

assess hypomagnesemia

Na < 135 mEq/L, nausea, muscle cramps, confusion, increased ICP

assess hyponatremia

When assessing for Alcohol disorder, need to

assess in a non judgemental manner , need to know when and how much, impt to know when they had the last drink/drug

thin upper lip, epicanthal fold(chinese eyes), maxillary hypoplasia(underbite)

assess infant for fetal alcohol syndrome

high pitched cry, hyperreflex, tachypnea, sneezing and yawning,

assess narcotic addicted infant

hypothermia, lethargy,poor sucking, episodes of apnea

assess neonatal sepsis

malaise, fever, IUD use, smoking, multiple sex partners, STDs

assess pelvic inflammatory disease

not sutured drain, not the location, expect drainage on dressing

assess penrose drain looks like a tournaquet tube

HTN, hyperglycemia, HA, palpitations, visual disturbance

assess pheochromocytoma

bowel sounds, NPO, mouth care, stool, flatus, TED hose, SCD,

assess postop

loss of sensation below injury, spinal shock, postural hypotension, thermoregulation alteration

assess spinal cord injury

Wernicke's Syndrome

associated with Thiamine deficiency, alcohol abuse can be a cause

Furadantin (nitrofurantoin) Side Effects

asthma attacks, diarrhea

turns back to stomach

at 6 months how can infant control movment

at 4-6 months

at what age do you introduce one new food at a time every 2 weeks.

9 months

at what age of infant can say dada

30 months (2y, 6 months)

at what age of toddler is sphincter control begin for toilet training

common medical diagnoses for low fat cholesterol restricted diets

atherosclerosis, cystic fibrosis

Brudzinski's

attempts to flex neck produces flexion at knee and thigh

Antidepressants: Heterocyclics Nursing Considerations

avoid alcohol CNS depressants wean off slowly

humidify air

avoid drying of mucosa with O2 therapy

Antimetabolit 2 methtrexate 2 considerations

avoid etoh, good mouth care, monitor hepatic and renal

vintablastne considerations

avoid iv and extravastion, antiseptic, acute bronchospasm if iv, zyloprim givent ot increase excretion and decrease uric acid buildup- urates

food for stroke victim

avoid milkbased products, liquids slowly, semisolid food best, upright half hour after eating

minimal concentration or mix with room air

avoid respiratory depression with O2 therapy

avoid contact with Mono clients for this duration

avoid saliva for 3 months

Internal skin care

avoid soap, powders lotion wear cotton loose fit

no fruit juice in baby bottles due to teeth and sugar

avoid this type of bottle to give a infant juice

conjuctivitis causes n trmt

bacteria, virus, allergies, warm moist compress, topical antibiotic, hydrocortisone opht oint

LDL

bad cholesterol that should be less than 139 mg/dL (fasting for 12 hours)

what is purpose of specific diet and restrictions for acute renal failure

balance electrolytes

not allowed in a renal diet

beans, cereal, citrus fruits

what may occur if a pt has an acute diverticular spout?

bedrest NPO - iv fluids NG tube possible surgery with temporary transverse colostomy

shock positioning

bedrest w/ extremities elevated 20, knees straight,head slightly elevated (modified Trendel)

MI positioning

bedrest, allow to use bedside commode for bowel; semifowlers position

treatment for pyelonephritis

bedrest, antibiotics, analgesics

implement glomerulonephritis care

bedrest, meds, I/O, daily weight, dialysis and diet

stage 1 of labor

beginning of labor to complete cervical dilation

Rh isoimmunization

besides pre-term labor, infection, abrupto placentae what are some other complications of amniocentesis

Heroin Implementatin

besides the general care 1. Methadone for maintenance - it a. blocks euphoric effects b. eliminates craving and withdrawal c. daily urine collected to monitor for drug use 2. Treat underlying emotional problems

Migraine meds

beta blockers, triptan preparations (active serotonin receptors), acet, NSAIDS, Topiramate (Topamax), ergotamines- dihydroergotamin (DHE)--take at start of headache

CHEM)#6 Topoisomearase action

binds to an enzyme that breaks dna strands

Antibiotics: Macrolide Actions

binds to cell membrane and changes protein function

stage 3 of labor

birth to delivery of placenta

thrid stage of labor

birth to delivery of placenta, increased gush of blood, lengthen umbilical cord, check for fragments

Antihistamines: Action

block effects of histamine

open angle (primary glaucoma)

blockage of aqueous humor flow, caused by trauma, tumor, hemorrhage

Antihypertensives: Ace Inhibitors Actions

blocks ACE in lungs

Antihypertensives: Beta Blockers Actions

blocks beta-adrenergic receptors

Anticoagulant Heparin Action

blocks conversion of prothrobin to thrombin

Antipsychotic Agents Actions

blocks dopamine receptors in basal ganglia

Antihypertensives: Angiotensin II Receptor Blockers Action

blocks vasoconstriction and aldosterone effects of aniotensin II

luekemia

blood forming tissue, wbc's and platelets

transmission of Hep C- antivirals treatment

blood/body fluids

Anticholinergics Side Effects

blurred vision, dry mouth, urinary retention, change in heart rate

Carbonic Anhydrase Inhibitors Side Effects

blurred vision, lethargy, depression

Antimetab # 5-Hydrea

bone depression, gi, rash

Anti-tumor atbs SE"s

bone marrow depression nv alopecia stoatitits heart failure septic shock

Top SE's

bone marrow suppression diarrhea NV Hepatoxicity

Antineoplastic: Antitumor Side Effects

bone marrow suppression, alopecia, stomatitis

evisceration

bowel externalized and separation of wound edges

Cardiac Glycosides Side Effects

bradycardia, nausea, vomiting, visual disturbances

Antitussive Agents Side Effects

bradycardia, respiratory depression, drowsiness, dizziness, anticholinergic effects

decerebrate

brain stem injury shows this posture and is very emergent

Hormonal agents indication

breast cancer

expose to air and sun, wear loose clothing, avoid soap on nipples

breast care antepartum

larynx, trachea and mainstem bronchi, tissue biopsy, remove aspirated objects or secretions

bronchoscopy is a scope thru upper airway to these lower airways

five danger signs of glaucoma

brow arching, halos, blurry, dimin. periperhal vision, headache/eye pain

raccoon eyes

bruising of both periorbital eccymosis

battle sign

brusing behind ear after skull fracture aka

Bleomycin considerations

bserve for pulmonary complications treat fever with acetmpohinan check breath sounds frequently

superficial partial thickness

burn shows pink to red painful skin burn

common medical diagnoses for high protein diets

burns, infection, hyperthyroidism

if cleitn pregnant with herpes, this procedure is done to prevent spread to baby

c-section to prevent spread to baby

treatment for varicella

calamine lotion, nails short, avoid asa

blood clotting, skeletal muscle contraction, sedative effect on CNS

calcium is used in the body to do these

4.5-5.2 mEq/L

calcium normal range

decubitus ulcer

can cause osteomyelitis, tissue maceration & infection to prevent: turning, draw sheet, air mattress, elbow/heel pads to relieve pressure on skin; protein, vitamins & minerals

Anti Impotence Nursing Considerations

can not take with grapefruit juice call PCP if erection lasting longer than 4 h

Antineoplastic: Antitumor Uses

cancer

Antineoplastic: Vinca Alkaloids Uses

cancer

Antifungals: Uses

candidiasis, oral thrush, histoplasmosis

stage 2 lyme disease

cardiac defects, neuro disorder

TURP, 3-way continuous bladder irrigation, traction on catheter, retrain bladder

care for BPH post-op

diet, test for diabetes with average risk(obese, 25+, hx, race) test= glycosylated Hgb test or glucose tolerance test, insulin is med of choice

care for GDM

antibiotics, fluids, warm douches, rest

care for PID

airway, epi 1:1000, IV fluids, O2, meds

care for allergic reaction

rest, nutrtion, moderate activity, avoid URI, avoid public places

care for cardiac disease for pregnant mothers must find signs of heart failure.

shock, Rhogam if needed, support, surgery

care for client with ectopic pregnancy

antibiotics, fluids, educate tampon use

care for client with toxic shock syndrome

heated environment, cap on head,

care for cold stress infant

large bore IV, minimize stimuli, O2, meds, monitor seizures and FHT

care for eclampsia

use warm shower or compresses, mild analgesics, ice packs

care for engorgment by doing these

avoid pregnancy for 1 year, don't use IUD, check hCG levels for one year

care for hydatidiform mole which is a undeveleoped placenta

glucose, feedings, and monitor BS every 4 hours

care for hypoglycemia

antibiotics, warm packs for comfort, breast support

care for mastitis

home bedrest, left lateral position, well balanced diet, weights, diversions

care for mild preeclampsia

antibiotics for 7-10 days, O2, discontinue feedings temporariliy

care for neonatal sepsis

encourage feelings, assess for suicide, assist with baby care, support group

care for postpartum care

massage uterus, pitocin to produce contractions, monitor for shock

care for postpartum hemorrhage

antibiotics, early ambulation, change peripads, nutrition, fluids

care for postpartum infection

bedrest, sidelying, uterine and weights checked, nutrition, relax, meds

care for pre-term labor

call for help, push pressure off of cord, place in trendelenburg or knee chest position

care for prolapsed cord after membranes rupture

trendelenburg position for 2-3 minutes, IV increased, O2

care for severe hypotension from a regional lumbar epidural block

hospital bedrest, FHT, IO, vitals, seizure precautions, meds

care for severe preeclampsia

Rhogam, vitals, check bleeding, pain, save tissue, support

care for spontaneous abortion before 20 weeks with persistent bleeding and cramps

full thickness

carred, waxy, white and painless burn

treatment for BPH or prostatic hypertrophy

catheter, cystostomy(urine bag), continuous bladder irrigation, prostatectomy

changing hormone levels

cause of postpartum depression

Fat Emboli

caused after a fracture of long bones when fat globules move into bloodstream; may occlude major vessels

hyperbilirubinemia: hemolytic anemia

caused by blood antigen incompatability within 24 hours of birth,

hyperbilirubinemia: breast milk jaunidce

caused by breast milk factor happens within 5 days, discontinue breastfeeding for 24 hours

renal failure, cirrhosis, sodium ingesting, CHF,

causes for fluid volume overload

malignant neoplastic disease, hyperparathyroidsim, excess intake

causes for hypercalcemia

alcoholism, GI suction, diarrhea, intestinal fistulas, diuretic or laxative abuse,

causes for hypomagnesemia

Antidepressants: MAOIs Action

causes increased concentration of neurotransmitters

renal failure, potassium supplements, burns, crushing injuries

causes of hyperkalemia

diarrhea, hyyperventilation, diabetes insipidus, alka-seltzer, not enough water ingestion

causes of hypernatremia

hypoparathyroidism, pancreatitis, renal failure, steroids, loop diuretics, inadequate intake

causes of hypocalcemia

vomitting, diuretics, excess of dextrose and water IV, low sodium diet, excessive water intake

causes of hyponatremia

fever, head injury, HTN, CNS infection, brain tumor, drug withdrawal, stroke

causes of seizures are

Chemo 4 hormonal action (leuprolide)(progestin)

causes tumor cell regression by unknown mechanism

Cytoan considerations

cbc, report hematuria, force fluids, monitor for infection, give antimentics

0.3-0.6 mg/dl

ceatinine level for infant (NPO for 8 hours)

normal bump on the head

cephalohematoma or caput succadenum are normal finding of rupture blood vessels on the head that looks like this

Internal radiation

cesium, radium, gold, brachytherapy

C

change in bowel, bladder habits

Antineoplastic: Hormonal Agents Actions

changes hormone input into sensitive cells

Antihypertensives: Beta Blockers Side Effects

changes in HR, hypotension, bronchospasms

Bulsufan- Considerations

check CBC and fluids to flush system of stomach to prevent stomatitis

6(MP) antimetab considerations

check liver function tests

pacemaker teaching

check pulse daily, request hand scanning at security check points, wear loose clothing over pacemaker, place cell phone on side opposite generator

check residual

check this first before intermittent feeding and every 4 hours with continuous feeding

2 cm

chest tubes must have water seal chamber with sterile water with this amount

pneumothorax

chest xray is perfromed after lung biopsy to check for this

preschooler

child age of associative play- follow the leader

toddler

child age of parallel play-play alongside but not with another

infant

child age of solitary play- own activity

assess pylonephritis

chills, fever, flank pain, malaise

common medical diagnoses for renal diets

chronic renal failure

soap and water

clean perineum and cathter with this before self inserting intermittent self catheter

Post op ileostomy, once peristalsis returns, whats the pts diet?

clear liquids progressing to solids low residue diet for 6-8weeks

hemorrhage

client at risk for this if prolonged clotting times exist

pressure for 5 minutes, check for swelling, discoloration, pain, numbness, and tingling

client care for post ABG Allen test is this and check for these

ICP and abdominal surgery (eye, brain)

clients are encouraged to deep breath but not cough in these types of surgeries ofr condition

Tetany

clinical neurological syndrome characterized by muscular twitching and cramps and (when severe) seizures.

Chemo # 2 Antimetabolites-action

closely counterfeits foot cells, division of cells is halted

glaucoma s/s

cloudly, blurry, artificial lights seem to have rainbows/halos (increased IOP, obstruction of aqueous humor)

The stimulants thar r most often abused...

cocaine, crack cocaine, anphedipines (sp), crystal --- their motors are running, running, running

what is included for Metabolic syndrome - syndrome X?

coexisting risk factors for developing type 2 DM 1) ab obesity 2) hyperglycemia 3) HTN 4) triglyceride level >200 5) HDL <35

stool softeners

colace is this type of med to decrease ICP

sample meal items for sodium restricted diet

cold baked chicken, lettuce with sliced tomatoes, applesauce

atelectasis

collapse of part or (much less commonly) all of a lung.

main RN teaching to parents regarding surgery of herschsprung?

colostomy TEMPORARY, closed when child is 17-22lbs

hyperthermia, hypotension, respiratory depression, n/v

common side effects of anesthesia

stage 2 of labor

complete dilation to birth

eclampsia

condition of pregnancy with HTN, proteinuria, tonic-clonic seizures, coma

early signs inc ICP

confusion, restlessness, pupillary changes

sarcoma

connective tissue

bulk foods, fiber, stool softeners, fluids

constipation and hemorrhoids during pregnancy implement

Antidiarrheals: Side Effects

constipation, anticholinergic effects

Iron Preparations Side Effects

constipation, dark stools, tachycardia

Antacids Side Effects

constipation, diarrhea, acid rebound

Antihyperlipidemic: Side Effects

constipation, fat-soluble, vitamin deficiency

common medical diagnoses for high roughage, high fiber diet

constipation, large bowel disorders

Laxatives/Stool Softeners Uses

constipation, preparation for sx and procedures

Cytoprotective Agents Side Effects

constipation, vertigo

illness that require precautions due to touching inanimate objects, turning patients, touching hands, bathing

contact precautions

what precautions for hepatitis

contact precautions and rest

pertussis

contagious bacterial disease through violent coughing

serosanquineous fluid

containing or consisting of both blood and serous fluid

Etiology of cancer 1=defect in cellular proliferation

continous growth and indiscriminate, TUMOR mass, pyramid effect

frequency

contraction time in minutes of beginning of one contraction to beginning of next

HTN, thromboembolic disease, diabetes mellitus

contraindications of oral contraceptives

Antiparkinson Agents Actions

converted to dopamine, stimulates postoynaptic dopamine receptors

school age

cooperative play with organized rules

decradron

corticosteroid used to decrease cerebral edema to decrease ICP

Antitussive Agents Uses

coughs due to URI, COPD

sample meal items for high roughage high fiber diet

cracked wheat bread, minestrone soup, apple, brussel sprout

acute MI, detected in blood in 3-5 hours

creatine kinase (CK) isoenzymes detect this

0-70 U/L child

creatine kinase CK level for child

55-170 U/L man

creatine kinase CK level for man

30-135 U/L woman

creatine kinase CK level for woman

0.6-1.5 mg/dl adult

creatinine level for adult (NPO for 8 hours)

0.4-1.2 mg/dl child

cretinine level for child(NPO for 8 hours)

vagotomy

cutting of vagus nerve (10) to decrease HCl secretion)

inflammation of bladder aka

cystitis

visualization of bladder

cystoscopy purpose

linea nigra

dark line from umbilicus to symphysis during pregnancy

acoustic neuroma

deafness(partial), benign tumor needs excision

sx of choice for menieres

decompression of endolymphatic sac w/ Teflon shunt

_______ in K leads to cardiac irritability

decrease

Flexion

decrease angle of joint

1200 - 1500 cc/day

decrease fluids to decrease ICP by this amount

subdural hematoma

decreased LOC, pupil dilation, personality change, slow onset

downs syndrome

decreased levels of AFP test may indicate this syndrome

Bronchodilators Action

decreases activity of phosphodiesterase

Anticonvulsants Actions

decreases flow of calcium and sodium across neuronal membranes

Antigout Agents: Actions

decreases production and resorption of uric acid

Carbonic Anhydrase Inhibitors Action

decreases production of aqueous humor in ciliary body

Antidepressants: Heterocyclics Uses

depression and smoking cessation

Antidepressants: MAOIs Uses

depression, chronic pain

Antidepressants: SSRIs Uses

depression, obsessive compulsive disorders, bulimia

Antidepressants: Tricyclics Uses

depression, sleep apnea

Huntington's s/s

depression/temper outbursts; Choreiform movts, restlessness, facial grimacing, arm movts, irrefular leg movts, twisting, turning, tongue movts., person is in constant motion by end of disease progression. Paranoia, demanding, memory loss, dementia, psychosis seen at end stage

if hypoglycemia, and unconcious, what should u admin?

dextrose 50% IV Glucagon 1mg IM/SQ follow with 15 mins of carbs when arosed

low urine specific gravity

diabetes insipidus has these two tests and the values are these

prevents sperm entering cervix

diaphragm is this method of birth control

position on back with knees bent, hands on abdomen

diaphragmatic or abdominal breathing exercise position

Antidiarrheals: Uses

diarrhea

Antibiotics: Macrolide Side Effects

diarrhea, confusion, hepatotoxicity, superinfections

Antibiotics: Fluoroquinolones Side Effects

diarrhea, decreased WBC and hematocrit, elevated liver enzymes (AST ALT), elevated alkaline phosphatase

Laxatives/Stool Softeners Side Effects

diarrhea, dependence, abdominal cramps, hypermagnesemia

low residue diet, fluids

diet for internal radiation implants

dysphagia

difficulty swallowing

drugs that can cause dysrhythmias

digitalis, propranolol

what med do you withhold 48 hrs before cardioversion

digoxin

Anticholinergics Actions

dilates pupil, causes bronchodialtion adn decreased secreations, decreases mobility and GI secreations

dx of menieres

dilation of membrane of labyrinth, Weber, Rinne

Spina Bifida Occulta

dimple overlying skin L5-S1; vertebral arch not completely closed.

serosa - pink brown discharge

discharge color for Day 4-9 pospartum

alba - yellow-white

discharge color postpartum day 10+

Antibiotics: Tetracyclines Side Effects

discoloration of primary teeth if taken by the mother during pregnancy, glossitis, rash, phototoxic reaction

Thrombolytics Action

dissolves or lyses blood clots

catact s/s

distortion, blurring, decreased color perception, annoying glare, double vision

acute renal failure phase of output drastic increase 4-5 l/day, increased BUN, Na and K lost in urine, increased mental and physical activity

diuretic phase of acute renal failure

Antiparkinson Agents Side Effects

dizziness, ataxia, atropine like effects

H2-Receptor Blockers Side Effects

dizziness, confustion, hypotension, impotence

Diuretics Side Effects

dizziness, orth hypotension, leukopenia

Narcotics Side Effects

dizziness, sedation, respiratory depression, hypotension, constipation

abd pain, n/v, suspected appendicitis

do not use enemas in these conditions

Antidiarrheals: Nursing Considerations

do not use with abdominal pain monitor for urinary retention give 2h before or 3h after other medications

how do you get Huntington's

dominant inheritance

myringotomy

done for acute otitis media; tympanic membrane incision to relieve pressure and release purulent fluid; no water can be allowed to enter the ear

salem sump

double lumen NG tube for decompression

extracting fake eye

draw lower lid down, slip out over lower lid

illness that require precautions due to contagions from cough, sneeze, talking, suction

droplet precautions

what type of precautions for rubella

droplet precautions

Antihistamines: Side Effects

drowsiness, dry mouth, photosensitivity, bronchospasm

Cytoprotective Agents Uses

duodenal ulcer

beginning of P wave to beginning of QRS complex

duration of PR interval

exhalation should be twice as along as inhalation for COPD pt.

duration of exhalation and inhale for pursed lip beathing

cesarean section

dystocia(abnormal labor), breech, fetal distress, gonorrhea, herpes, prolapsed cord, PIH, placenta previa or abruptio placentae is and indication for this.

unaffected side down affected side up

ear drops how should pt. lie down

swelling or tenderness

ear irrigation is contraindicated for these symptoms

head is tilted and drained on affected side

ear irrigations, clients head needs to beon this side

Diet teaching for ulcers

eat 3 meals per day avoid milk, coffee, caffeinated beverages

before testing for PKU, you want to ensure what measures is done beforehand with the newborn?

eat before collection

turners sign

ecchymosis around flanks of retroperitoneal bleed

cullens sign

ecchymosis around umbilicus showing retroperitoneal bleed

noninvasive sound waves used to examine cardiac structures

echocardiogram is used for this

Dooxrubican(adria) considerations

ekg, avoid IV filtration, good mouth care, and close vitals

Electrolytes Side Effects

electrolyte imbalances

blood test to show hepatitis

elevated AST, ALT, and prolonged PT

infection

elevated WBC and temperature, positive cultures s/s of this surgery complication

Antihyperlipidemic: Uses

elevated cholesterol, reduce incidence of cardiovascular disease

Spica cast

encases a portion of the trunk & 1-2 extremities; potential complications severe impairment in mobility: skin breakdown, respiratory dysfunction, constipation, joint contractures

BPH

enlarged prostate compression on urethra for men older than 50

bed wetting aka

enuresis

urethra opening on penis dorsal, ventral

epispadias/hypospadias

carcinoma/edenocarcinoma

epithelial tissue

Celiac dx (cause, risk, tx/diet

error of wheat and rye metabolism risk: malnutrition, diarrhea, FAILURE TO THRIVE tx: Gluten-free diet (no wheat, oat, rye, barley)

Antibiotics: Macrolide Med Names

erthromycin, Cleocin (clindamycin)

lyme disease stage one from tick bites assess

erythematous papule bulls eye, flu, lymph node swelling

Bone-Reabsorption Inhibitors: Biophosphonates Side Effects

esophagitis, arthralgia

check for bruit this often for hemodialysis

every 8 hours

When is ear irrigation contraindicated?

evidence of swelling/tenderness

Hyperextension

excessive increase in angle of joint

diabetes insipidus

excessive urine output, dehydration, excessive thirst, weakness, weight loss s/s of this

what is positive TB mantoux test states

exposed and infected only

Atypical Antipsychotic Agents Side Effects

extrapyramidal, anticholinergic, sedatives, ortho hypotension

assessment findings of herchsprungs dx in child

failure to gain wait ribbion like - foul smelling stool visible peristalsis

assessment findings of herchsprungs dx in newborn:

failure to pass meconium refusal to suck ab distention

hyperopia

farsightedness

assess TB

fatigue, night sweats, purulent sputum

sample meal items for low phenylalanine diet

fats, fruits, jams, low phenylalanine milk

transmission of Hep A - no treatment

fecal/oral

unaffected side

feed brainattack victim on this side

LOA

fetus back on left side of mother pelvis facing toward the back with the head presentation is this position

lightening

fetus descending into pelvis where primipara can occur 2 weeks before delivery or multipara when labor begins

Antipyretic Uses

fever

assess glomerulonephritis

fever, chills, protein and blood in urine, edema, HTN, abdominal/flank pain

20 cm

fill suction control chamber of chest tube with sterile water with this amount

lanugo

fine hair over shoulders foread nose cheeks

CK-MB def

first enzyme tube to be elevated after MI; appears 3-6 hrs; peaks 18-24 hrs; lasts 3 days

fourth stage of labor

first four hours after delivery

stage 4 of labor

first four hours after delivery

Turners sign

flank bruising indicating retroperitoneal bleeding

detached retina s/s

flashes of light, floaters, curtain coming down, confusion

Electrolytes Uses

fluid and electrolyte imbalances, osteoporosis

One important teaching for mom with infant of pyloric stenosis surgery?

fold diaper - avoid irritate site

ET3-chemical related

food additives nitrates diet smoking phamacy-stilebestrol ETOH

green veggies, nuts, banans, oranges, peanut butter, chocolate

foods rich in magnesium

coffee, tea, vanilla, chocolate, bananas

foods that excellerate hypersecretion of catacholamines are

mutilation, encourage expressed feelings, models

for a preschooler what is taught to parents about the childs psyche before surgery

someone who has had the surgery before and talk about it helps

for adolescents this implementation is helpful before surgery to minimize fear

implement cystitis care

force 3000 ml/day fluids, acidify urine, antibiotics, void after intercourse, perineal care after defecations

antimetabolite cytrabine considerations

force fluids, oral hyigene

Cytoprotective Agents Action

forms a barrier on ulcer surface

UTI

foul smelling urine, elevated WBC, 5-8 days post op

position to place your pt with a bowel obstruction

fowlers facilitates breathing

not allowed in a clear liquid diet

fruit juices with pulp,milk

sample meal items for low fat cholesterol restricted diet

fruit, vegetables, cereals, lean meat

Nursing management #2 Radiation

gamma and beta rays alpha rays

Post op of Billroth I or II what would you see/assess?

gastric decompression via Levin or Salem Sump tube NG listen for bowel sounds, observe drainage for volume and blood

sample meal items for clear liquid diet

gelatin dessert, popsicle, tea with lemon, ginger ale, bouillon, fruit juice without pulp

hyperglycemia after 20 weeks

gestational diabetes mellitus GDM,

Hydrea considerations

gi symptoms toxic teach

Antihypertensives: Ace Inhibitors Nursing Considerations

give 1 hour before meals, or 3 hrs after Change positioning slowly Monitor VS

Antihistamines: Nursing Considerations

give w food use sunscreen avoid alcohol assess respirations

7 or less coma, 13-15 A/O,

glascow coma scale shows coma with this number and Aand O with these numbers

kidney infection of glomerulus occurs 10 days after skin or throat infection

glomerulonephritis

What meds increase risk of hyperglycemia while on insulin?

glucocorticoids thiazide diuretics thyroid agents estroge

head injury meds

glucocorticoids (Decadron), mannitol, furosemide (for ICP); barbs (decrease cerebral metabolic rate)

glucose levels for the previous three months.

glycosylated Hgb test is this

breast feeding

golden yellow stool from this feeding

HDL

good cholesterol where low levels are bad (fasting for 12 hours)

Impaired oral mucus membrane, sotmatitis

good oral hyigene

oranges, apricots, beans, potatoes, carrots, celery, raisins (CRAB COP)

good potassium rich foods are

cancer

group of many diseases of multiple causes, can arise in any cell any cell that is able to evad regulatory controls over cell proliferation

moving w/ blind pt

have client follow attendate when walking by lightly touching attendant's elbow (1/2 step ahead)

contusion head injury

head injury type that shows signs of decorticate, decerebrate

Antivirals Side Effects

headache, dizziness, GI symptoms

Anti Impotence Side Effects

headaches, hypotension, priapism

Nonunion

healing has not occurred 4-6 months after fracture; insufficient blood supply, repetitive stress on fracture site, infection, inadequate internal fixation; treated by bone grafting, internal fixation, electric bone stimulation

Delayed Union

healing of fracture is slowed; caused by infection or distraction of fractured fragments; will see increase in bone pain

phenylketonuria, hypothroidism, galactosemia (inable to metabolize sugar), sickle cell disease, HIV

health screeing for newborn, (5)

common medical diagnoses for sodium restricted diet

heart failure, hypertension, cirrhosis

kegel exercises, monitor for infection

help care for urinary frequency and UTI during pregnancy

Antimetabolite#4-cytarabine se's

hematologic abonomalities, nausea, vomiting, rash weight loss

Anticoagulant Heparin Side Effect

hematuria, tissue irritation

complications of renal transplant

hemorrhage, infection, rejection signs, check weights

Antiplatelet Agents Side Effects

hemorrhage, throbocytopenia

remove plug, empty contents, place flat, compress completely then replace plug to facilitate suction

hemovac drain is significant looks like an accordian

Antitubercular Agents Side Effects

hepatitis, peripheral neuritis

Antineoplastic: Alkylating Agents Side Effects

hepatotoxicity, bone marrow suppression

Antifungals: Side Effects

hepatotoxicity, throbocytopenia, leukopenia, hemorrhage, pruritus

Immunosuppressants Side Effects

hepatotxicity, nephrotoxicity, leukonpenia, thrombovytopenia

what kind of diet do you want to prescribe a pt w/renal failure?

high calorie, LOW PROTEIN diet alteration in protein metabolism -

what type of diet for glomerulonephritis

high calorie, low protein diet

what diet for hepatitis client

high carbohydrate, moderate fats and proteins, no alcohol

Compartment syndrome

high pressure within a muscle compartment of an extremity compromise circulation; pressure may be internal (bleeding) or external (casts); if left untreated neuromuscular damage occurs withing 4-6 hour; limb can become permanently useless within 24-48 hours; will see unrelenting pain out of proportion to injury and unrelieved by pain medications, decreased pulse strength, numbness and tingling of extremity,possible cyanosis and pale cool extremity.

Chemo 5- alakaloids indications

hodgkin's lymphoma cancers

no douching, no enemas, no sex, non stress test q 1-2 weeks

home care for placenta previa that is controlled

least allergenic to more allergenic

how are food allergies introduced and detected when introducing new foods

5 weeks

how early can pregnant client have ultrasound

2-3" then urine is flowing insert another 1 inch

how far is cathter inserted for woman

anxiety with strangers

how is 8 month child act towards others

measure with pt. flat in bed or 45* up

how is CVP measured

IM vastus lateralis, or deltoid, tender

how is Hep B immunization given and s/e

PO, little side effects

how is IPV immunization given

position on right side for 1-2 hours

how is client to be positioned after liver biopsy

potassium supplements of , <40 mEq/L IV with cardiac monitor

how is potassium supplements administered

measure at highest level of fluxuation

how is the measure of CVP perfromed

no more than 6 hours before sex best used with spermicial gel

how long may the diaphragm be placed before sex

use alternate form of birth control for 3 months

how long should a different form of birth control be used directly after vasectomy

100% 15 lpm

how much O2 for NRB maskwith resevoir bag 2/3 full

75% O2 8-11 lpm

how much O2 is partialrebreather given to client with resevoir bag 2/3 full

20 ml NS before and after each NG tube med and each feeding

how much and how often is water flushed through NG tube

no more than 1000 ml taken at one time

how much fluid is relieved for a thoracentesis

4% oxygen + room air 21%

how much oxygen % for each liter of given

dry sterile dressing, iv fluids, manometer, tubing all changed every 24 hours

how often is CVP mechanism changed

every shift

how often is drainage assessed for intestinal NG tube

yearly after age of 40

how often is mammoagrpahy done for female

lie on unaffected side

how should atelactisis client lie in bed

gradually lift head 30* first hour, 45* send 2 hours

how should head elevation be positioned post op liver biopsy

wipe meatus toward rectum with swab, sterile procedure

how should meatus be wiped for cathter of woman

store it dry in a clean container, never in a antiseptic solution

how should the self catheter be stored

three slow deep breaths slowly exhaling, breath in and cough several times during expiration,

how to cough correctly

open stopcock and fill manaometer with 18-20 cm of IV fluid

how to fill the line of CVP manometer

nose to ear to xiphoid process, mark distance

how to measure NG tube

head back and twoard affected side soe fluid will flow from inner to outer canthus

how to position client witheye irrigation

bend head forward insert in nare to opposite ear, swallow sips of water

how to position head for NG insertion

place in postions to facilitate drainage of secretion into large airways

how to postural drainage

use pillow over incsion site

how to protect incision site from cough technique

breath in nose pursed lips breathe out of mouth

how to pused lip breathing exercise

have extra cushion of hormones

how to remember cushings syndrome

verify by insert with air into tube and auscultate over stomach

how to verify placement of tube before irrigation of NG tube

autonomic hyperreflexia meddd

hydralazine (Apresoline)

hyperbilirubinemia:physiologic jaundice

hyperbilirubinemia from poor hepatic function 24 hours after birth, no treatment needed, last for 5 days

>5.0mEq/L EKG dysrhythmias, weakness, paralysis, diarrhea, nausea

hyperkalemia assess

decrease respirations and decrease urine output

hypermagnesemia shows these signs

Antihypertensives: Ace Inhibitors Uses

hypertension, CHF

Antihypertensives: Beta Blockers Uses

hypertension, angina, SVT

Antihypertensives: Alpha 1 Adrenergic Blockers Uses

hypertension, benign prostatic hypertrophy, reflex tachycardia

Antidepressants: MAOIs Side Effects

hypertensive crisis when taken with tyramine-containing foods (cheese, liver, beer, wine), photosensitivity

blood sugar 40-50 mg/dl

hypoglycemia of infant in first 24 hours

Hypoglycemic Agent: Side Effects

hypotension, bronchospasms

Antihypertensives: Calcium Channel Blockers Side Effects

hypotension, renal failure, angioedema

Antianginals Side Effects

hypotension, tachycardia, headache, dizziness

hemorrhage or shock complication of surgery

hypotensive increased pulse cold clammy skin s/s of

Thyroid Replacement Agents Uses

hypothyroidism, Graves' disease

defib first

if AED available and the client is a witnessed cardiopulmonary arrest then this is done first AED or CPR

inaccurate low reading

if BP cuff is to long or too wide what type of reading will be expected

inaccurate high reading

if BP is too short or narrow what type of reading is expected

hypervolemia or poor cardiac contractilty

if CVP measures > than 12 cm H2O this is why

no cathter is to be inserted

if blood is found on the meatus of the urethra than this is avoided

when should infant have expert eye exam?

if born before 36 wks or less than 2000 g at birth

FHT unchanged

if care for prolapsed cord is successful what is the sign of success

use alternative form of birth control

if client misses two days of oral contraceptives what is told to client

less than 3 movments in one hour

if decreased fetal movements should be reported to Dr.

hypotension

if drain more than 700ml of urine at one time may cause this

change position of client

if feel resistance of irrigationo f NG tube do this for the client to free any kinks

deep tendon reflexes

if hypomagnesemia shows this sign

hold feeding

if residual stomach contents before feeding is 100 ml what dod you do

constant bubbling

if this occurs in water seal chamber it means an air leak

encourage to speak or cough

if upper airway is obstructed encourage victim to do this

besides drugs, what can cause increase BG levels requring insulin?

illness, infection, stress

Splinting

immobilization of affected part to prevent soft tissue from being damaged by bony fragments

Antifungals: Action

impairs cell membrane

airway, elevate head 15-30*, minimize activity

implement acute phase of brain attack

informed consent, valium, sync on 25-360 joules, check monitor

implement cardioversion for rhythm disturbance

NPO, NG tube, I/O, drainage, bowel sounds, CVP, ABG's, monitor, catheter

implement care for abd injury

sitting position, catheter, check rectum for fecal mass, medication

implement care for autonomic hyperreflexia

good posture, body mechanics, good shoes, pelvic tilt exercises

implement care for backache during pregnancy

well fitting bra, and wear bra at night

implement care for breast soreness during pregnancy

assess sucking ability, airway, surgery, guard suture line

implement care for cleft lip and palate

antacids, avoid phosphorus antacids (it will decrease calcium), decrease fatty fried foods

implement care for heartburn during pregnancy

move left side position first, O2 mask, IV fluids increased, stop oxytocin

implement care for late decelerations during labor

pacifier, assess muscle tone, vitals, nutrtion, wrap snug, hold and rock tightly

implement care for narcotic addicted infant

left lateral position, increase IV, O2

implement care if mild/moderate hypotension from a regional lumbar epidural block

elevate presenting part off of the cord, call for help, knee chest position, O2, start IV

implement care to a mother with a prolapsed cord

turn mother on left, O2, check for prolapsed cord, start IV

implement care to mother if FHR is iregular

monitor shock, humidified O2, thoracentesis, chest tube

implement chest trauma

slow deliberate movements, support stockings

implement dizziness during pregnancy

tepid solution, no more than 18" above rectum, 4" inserted rectum,

implement enema

low fowlers, no coughing NPO, cover viscera with steril saline dressing, notify physician

implement evisceration

force isotonic fluids, I/O, daily weights, skin tugor, urine specific gravity assessed

implement fluid volume deficit

diuretics, restrict fluids and sodium, assess breath sounds, edema, semi-fowlers position

implement fluid volume overload

Assess LOC, Na levels, I/O, daily weight, restrict water intake 500-600/day, diuretics, hypertonic solution

implement for SIADH

NS IV, vasopressors, hydrocortisone, vitals, bedrest

implement for addisonian crisis

monitor hypoglycemia, hyponatremia, hyperkalemia, hormone replacement and specific diet

implement for addisons disease

fluid/electrolyte balance, vitals, urinary output, IV pain meds, and wound care, grafting for full thickness

implement for burn care

monitor glucose levels, specific diet, surgery for adrenalectomy or hypophysectomy(pituitary gland removal)

implement for cushings disease (the over active adrenal gland)

avoid stress, promote rest, avoid coffee and stimulating foods, postop care after adrenalectomy or medullectomy

implement for pheochromocytoma

hypotonic or isotonic solution, fluids, diuretics, calcitonin, mobilize, surgery for hyperparathyroidism

implement hypercalcemia

meds, restrict potassium intake, peritoneal or hemodialysis

implement hyperkalemia

discontinue oral or IV Mg, monitor respirations, cardiac rhythm, reflexes, IV calcium to antagonize cardiac depressant

implement hypermagnesemia

hypotonic solution, I/O, daily weight, decrease sodium in diet

implement hypernatremia

oral caclium supplements with OJ, seizure precautions, meds, seizure needs

implement hypocaclemia

monitor cardiac rhyth and reflexes, swallow ability, seizure precautions, foods rich in magnesium

implement hypomagnesemia

I/O, daily weight, increase intake sodium rich foods, water restriction, IV LR or NS

implement hyponatremia

elevate head 30-45*, glascow coma scale, vitals, avoid neck flexion and head rotation

implement icreased ICP care

swallowing, reorient, ROM skin care, communication needs, elimination needs

implement intermediat phase of brain attack

30-50 ml water, check for resistance, kinks, withdraw solution and record

implement irrigation of NG tube

CT scan, LOC, vitals, I/O, pupils PERRL), CSF leakage in nose and ears, elevate head 30*

implement monitor and reassess head injury

bedrest sidelying or Trendlenburg position, ultrasound to locate placenta, amniocentesis (lung maturity), Hgb, Hct, check bleeding

implement placenta previa care

clamp tube, deflate balloon, exhale, remove 6" every 10 minutes until stomach then remove all

implement removal of intestinal NG tube

O2, side lying, suction, reorient, meds teaching, reduce stimuli

implement seizure care

protect from injury, don't restrain, don't insert anything in mouth, monitor for onset, duration and pattern of seizure

implement seizure safety

sterioids, hyperbaric O2 therapy, bladder/bowel training, emotional support client and family teaching

implement spinal cord injury care

room temp, use pump, elevate head, check q 4 hours, mouth care, I/O

implement tube feeding for levin/salem sump

hypertonic fluid(mannitol), diuretic, hypothermic therapy, barbiturate therapy, glucocorticoids(decadron), seizure precaution,

implementation for head injury to decrease ICP

anticoagulants

implementation of DVT

second day post op, O2, anticoagulants (heparin), IV fluids

implementation of PE

antibiotics and force fluids , CS sample

implementation of UTI

second day post-op, suction, postrual drainage, antibiotics, turn and cough, deep breathing

implementation of atelactisis and pneumonia

low fowlers position, no coughing, NPO, notify physician

implementation of dehiscence post op surgery complication

monitor vitals, replace blood

implementation of hemorrhage

trach avail, croupette or mist tent, cotton clothes, humidified O2, IV fluids, meds, prop with pillow, HR for hypoxia

implementation of hospital care for croup

antibiotics, aseptic techniques, good nutrition

implementation of infection to wound from surgery

nasogastric suction, IV fluids, decompression tubes

implementation of paralytic ileus

treat cause, O2, IV fluids

implementation of shock

catheterize pt. or have client stand if tolerated

implementation of urinary retention

Malunion

improper alignment of fracture fragments; may develop with premature weight bearing

hyperoxygenate, deep breath, suction trach tube, remove dressing, open kit, sterile gloves, remove inner canula, clean canula withperoxide, rinse sterile H2O, change ties, keep old in place, sterile dressing

in order for trach care

c, f(non citrus)v, p,m,e, oj

in what order are foods with possible allergens introduced

presbyopia

inability to focus on near things w/ age

encopresis

incontinent of stool, cause of constipation

Extension

increase angle of joint

Iron Preparations Actions

increase availability of iron for hemoglobin

diet of fluid intake and high in fiber, fruits and vegetables and grains help bowel eliminations

increase peristalsis

late signs inc ICP

increased BP, decreased pulse; Cushings triad: widenening pulse pressure, increase sys. pressure, bradycardia

chloasma

increased pigmentation on face during pregnancy

what bloodwork tells signs of acute renal failure

increased potassium, Ca, Na, BUN, creatinine

Antidiarrheals: Action

increases GI motility, blocks effect of dopamine in chemoreceptor trigger zone

Cardiac Glycosides Action

increases force of myocardial contraction, slows rate

Attention Disorder Agents Action

increases level of catecholamines

Thyroid Replacement Agents Action

increases metabolic rate

I

indegestion or or difficulty swallowingg

Antibiotics: Tetracyclines Uses

infections, acne, prophylaxis for ophthalmia neonatorum

tetanus

infectious disease of the nervous system

keratitis

inflammation of cornea (steroids, except w. herpes simplex)

uveitis

inflammation of iris, ciliary body, choroid

chalazion

inflammatory cyst on eye

Antidepressants: SSRIs Actions

inhibits CNS uptake of serotonin

Antivirals Action

inhibits DNA and RNA relpications

Antineoplastic: Antimetabolites Actions

inhibits DNA polymerase

H2-Receptor Blockers Action

inhibits action of histamine and gastric acid secretions

Antitubercular Agents Action

inhibits cell and protein synthesis

Antihyperlipidemic: Actions

inhibits cholesterol and triglyceride synthesis

Antihypertensives: Calcium Channel Blockers Actions

inhibits movement of calcium across cell membrane

NSAIDS Action

inhibits prostaglandin synthesis

Antibiotics: Tetracyclines Actions

inhibits protein syntheis

Antibiotics: Aminoglycosides Action

inhibits protein synthesis in gram-negative bacteria

Diuretics Actions

inhibits reabsorption of sodium and water, blocks effects of aldosterone

Bone-Reabsorption Inhibitors: Biophosphonates Action

inhibits resorption of bone

Antidepressants: Tricyclics Actions

inhibits reuptake of neurotransmitters

Antibiotics: Cephalosporins Actions

inhibits synthesis of bacterial cell wall

Antibiotics: Penicillins Actions

inhibits synthesis of cell wall

250 ml every 2 hours

innstruct client to drink this amount of water

sucking sound when w/ open pneumo

inspiration and expiration

void before procedure do avoid aspirating bladder, and the use of ultrasound

instruct client to do this before amniocentesis

clamp tube, instruct client to exhale, remove tube

instruct client todo this when removing NG tube

Antidysrhythmics Action

interfere with electrical exciablility of heart

Antineoplastic: Antitumor Action

interferes with DNA and RNA sythesis

Antibiotics: Fluoroquinolones Actions

interferes with DNA replication in gram-negative bacteria

Chemo 3 antitumor ATB's action

interferes with RNA and DNA synthesis

Atypical Antipsychotic Agents Actions

interferes with binding of dopamine in the brain

Antineoplastic: Vinca Alkaloids Action

interferes with cell division

Chemo 5- Vinca alkaloids action

interferes with cell division

Antiplatelet Agents Actions

interferes with platelet aggregation

Antineoplastic: Alkylating Agents Action

interferes with rapidly reproducing DNA

Anticoagulant Coumadin Action

interferes with synthesis of vitamin 5-dependent clotting factors

>4 pH

intestinal aspiration pH will be this level

Iron Preparations Uses

iron-deficiency anemia

false labor

irregular contractions, discomfort is abdominal, contractions decrease with either rest or activity, no cervical changes

rubella (german measles) of rash on face thne body, who to isolate from

isolate from pregnant women

how long must a chicken pox child stay at home

isolation until vesicles are crusted

meds for TB

isoniazid INH, rifampin, pyrazinamide, ethambutol

Oncovin considerations

iv, extravation, reflex checs, sensory and motor function, zyloprim

not allowed in a full liquid diet

jam, fruit, solid foods, nuts

kegel exercises, tighten and hold muscle for a 3 count relax for 10 times, TID, avoid caffeine

kegel exercise is taught like this and avoid this beverage due to postpartum urinary incontinence

BUN/creatinine

kidney function test

Menieres disease

labyrinth dysfunction, inner ear disorder that affects balance and hearing (caloric stimulation test- tests reflexes by warming/cooling inner ear w/ water)

hyperbilirubinemia: breast feeding jaundice

lack of breast milk intake, feed more frequently

internal sealed examples

lead container and long handled forceps in room to dislodge save all dressings and bed linen till source removed urine feces and linens not radioactive dont touch rad source pt. bedrest while implant put in place position of source verified by radiography

External radiation

leave radiology markings intact on skin avoid creams and lotions, deodorants, perfumes(only vi A and D) lukewarm to clean area assess for reed adminster antimetics, analgesics observe skin, mucous membranes, and hair for se's no hot water bottle, dont expose to sun or tanning bed cotton

Cardiac Glycosides Uses

left-sided HF

increase calcium intake, dorsiflex feet, local heat

leg cramps during pregnancy

Antineoplastic: Alkylating Agents Uses

leukemia, multiple myeloma

Chemo 1- Alkylating agent Indications

leukemia, multiple myeloma

Antineoplastic: Hormonal Agents Side Effects

leukopenia, bone pain, hypercalcemia

Antithyroid Agents Side Effects

leukopenia, rash, thrombocytopenia

station

level of presenting part in relation to imaginary line bewteen ischial spine of pelvis = 0, -5= 5 cm above ischial spine, +5 is 5 cm below ischial spine

which tube decompresses stomach?

levin or salem sump

transverse

lie of fetus are crossed at right angles

longitudinal

lie of fetus is parallel

oblique

lie of fetus is slight angle off true transverse

If pt arrives at clinic with fibrous faty masses at inject site from DM whats this called?

liphypertrophy

If pt arrives at the clinic with dimpling or pitting on arm, what is this called/cuased from?

lipoatrophy - loss of subq fat and appears as slilght dimpling or serious pitting

Antimetab #3 (6-MP) Mercap SE's

liver dmage, bone depression, infection, alopecia, and bleeding

Anti-tumor's atbs Cursing considerations

look for septicemia look for extravastion at insertion site for pain, and redness after injection that lasts for 48 hours (ulcerations)

hemianopsia

loss of half of visual field

Diet for menieres?

low Na (2,000 mg), avoid caffeine, nicotine, ETOH

type of diet to prepare for surgery for hirschsprung?

low fiber high calorie high protein

What does a pale pink stoma indicate?

low hct and hgb levels

purpose of low phenylalanine diet

low protein diet to prevent brain damage from imbalance of amino acids

ET3- Genetic components

lung breast cancer leukemia uterine cancer colon cancer neuroblatoma

lymphoma

lymphoid tissue

depressant

magnesium acts as a

1.5-2.5 mEq/L

magnesium normal range

confusion

main symptom for sodium imbalance is

What is the RN Priorty if you suspect your pt has appendicitis??

maintain NPO status IV fluids to prevent dehydration No alalgesics until cause of pain determined

what type of infants are most prone to pyloric stenosis?

male, white, full-term

What are two ND with cystic fibrosis?

malnutriton failure to thrive

what test diagnose TB

mantoux skin test 10 MM positive

Close reduction

manual manipulation or traction of fracture

not allowed in a low fat cholesterol restricted diet

marbled meats, avocados, milk, bacon, egg yolks, butter

main RN assessment while preparing child for surgery for herschsprung?

measure AB girth

tonometry

measure intraocular pressure, pt will be recumbent

not allowed in a low phenylalanine diet

meat, eggs, beans, bread

internal sealed source radiation

mechanically positoined source of radioactive material placed in body or tumor

antihistamine, bronchodilator, vasopressor, corticosteroids

meds for allergic reaction

phenobaribital, methadone, paregoric, diazepam, chlorpromazine

meds for narcotic addicted infant

mag sulfate, apresoline, valium, procardia

meds for severe preeclampsia

valium, versed or demerol

meds the client will recieve before a bronchoscopy

digitalis, isuprel, quinidine, atropine

meds to improve mycardial contraction to treat for shock

mannitol and lasix

meds to maintain adequate urine output

antibiotics, cardiac glycosides, diuretics, andrenergics/sympathomimetics

meds to treat for shock

mengional sacoma

meniges

pain relief

mild-tylenonl, antimetic, glucocorticoids, antidepressants moderate- weak narcotics, coedine severe-storng narcotics

sample meal items for full liquid diet

milkshakes, soups, custard, all clear liquids

Antibiotics: Penicillins Uses

moderate to severe infections, syphilis, gonococcus infections, Lyme disease

Narcotics Uses

moderate to severe pain, preoperative, postoperative

avoid milk, stay upright after eating, semisolid foods

monitor and teach swallowing aids

Implications for Bone Dep

monitor bleeding in everyting including pee and stool. avoid im injections and rectal temps apply pressure to venous sites

investigate any redness, swelling, cracking or bleeding which shows infection

monitor breast care postpartum complications

antimetabolite considerations

monitor for infection, avoid extravastion

Luekaran Considerations

monitor for infection, avoid im injections when palteltet count is low to minimize bleed, check cbc's

Nursing considerations- antimetabolites

monitor hemopoetic fucntion good mouth care small frequent feedings counsel with wig good skin care photosensitivity precautions infection control precautions

Implications for n&V

monitor i&o, nutrition, antimetics prn, smaller meals

bulb type drain, monitor amount and character of drainage, notify bright red or increased amounts

monitor jackson-pratt drain looks like a bulb

Antigout Agents: Nursing Consideration

monitor kidney stones Give w milk, food, antacids

Bipolar Disorder: Nursing Considerations

monitor serum levels give with meals increase fluid intake

below level of insertion, clamp for only a second to check for leaks

monitor system of chest tubes for cleint

Alcohol Withdrawl implementation

monitor their puslse, elevated pulse rate r a concern - watch to see if they progress into alcohol withdrawl syndrome

observe for fluctuation in water sealchamber

monitor this occurance in the chest tube system

Antihypertensives: Calcium Channel Blockers Nursing Considerations

monitor vs caution position change monitor edema (face swelling, SOB)

Antihypertensives: Angiotensin II Receptor Blockers Nursing Considerations

monitor vs do not chew or divide sustained release tablets

continuous passive motion

motion performed by a mechanical device that moves a joint slowly and continuously through a controlled ROM, aids in recovery after joint surgery, dec tissue stiffness, prevents scar tissue

Rotation

move around central axis

Abduction

move away from midline

abduction

move away from midline (take a child away)

Adduction

move toward midline

What is a teaching you would want to give a patient taking Carafate for a Hiatal Hernia

must take 1 hour before meals - will coat the stomach

what meds to avoid w/ glaucoma

mydriatics (atropine)

VINCA #1 Vinblastine SE's

n,v, somatitis, alopecia, loss of reflexes, bone marrow depression

s/s menieres

n/v, incapacitating vertigo, tinnitus, pressure feeling in ear, progressive decreased hearing on involved side, nystagmus, headache

N

nagging cough or hoarsness

anesthesia, barbiturate injection, insulin shock, spinal cord injury

name 4 types of distributive shock of neural induction

each shot at 2, 4, 6, 15-18months, 4-6 years , (Td) booster 11-16 years

name each time needed for the DTaP immunization

1.2-4 pounds, 2.12-14, 3.8-12

name normal weight gain in every trimester.

actinomycin d

nausea bone depression

Antimetabolite 1- 5(FU)

nausea, stomatitis, gi ulceration, D, bone dep, liver dysfunction, alpoecia

Antineoplastic: Antimetabolites Side Effects

nausea, vomiting, oral ulcerations, bone marrow suppression, alopecia

Bleomycin ATB#2 SE's

nausea, vomiting, pulmonary fibrosis, fever, bone dep

myopia

nearsightedness

neuroblastoma

nerve cells

Thyroid Replacement Agents Side Effects

nervousness, tachycardia, weight loss

Antacids Action

neutralize gastric acids

Anti Impotence Contraindications

nitrates, alpha blockers

Types of nonmechical obstruction aka paralytic ileus

no mechanical blockage - absence of peristalssi ab trauma/surgery spinal injury periotonitis/ acute appendicits wound dishisence

8-20 mg/dL

normal BU levels for all under 60 yo

7-18 mg/dL over 60 y/o

normal BUN level in adult over 60 yo

15 bpm above baseline

normal FHR variability acceleration

HCO3 22-26 meq/L (renal)

normal HCO3

child 35-45%

normal Hct child percentage of RBC

man 42-50%

normal Hct male percentage of RBC

woman 40-48%

normal Hct woman percentage of RBC

PaCO2 35-45 mm Hg

normal PaCO2

80-100 mm Hg

normal PaO2

SaO2 95-98%

normal SaO2

5,000-10,000mm3

normal adult WBC

child 11-12.5 g/dl

normal child Hgb/100ml

woman 12-16 g/dl

normal female Hgb/ 100 ml

120-160 bpm

normal fetal HR

3.5-5.5 g/dl

normal levels of serum albumin

man 13-18 g/dl

normal male Hgb/100 ml

acidosis >7.35-7.45< alkalosis

normal pH

5,000-13,000mm3

normal pediactric WBC

100,000-400,000/mm3

normal platelet count(thrombocyte count)

3-7 days

normal postpartum blues occurs these days postpartum

3.5-5.0 mEq/L

normal range of potassium

135-145 mEq/L E

normal range of sodium

3-12 cm H2O

normal readings of CVP

30-60 with 15 seconds of apnea

normal resp rates for newborn

length 19-21 inches, head 13-14 inches, chest is one inch less of head, 6-9 lbs.

normal weight length and head and chest for newborn

Glucose tolerance test normal/dm

normal: <140 140-200: GTT >200 diganose - DM

purpose of full liquid diet

nutrition without chewing

observe color and gastric pH (<4.0)

observe gastric contents for this

O

obvious change in wort or mole

what are signs of kidneyrejection

oliguria, fever, proteinuria, tender kidney

s/s MI u might not remember

oliguria, low grade fever (rises to 100-103 within 24 hrs and lasts 3-7 days)

tylenol

one type of pediatric antipyretics

Carbonic Anhydrase Inhibitors Uses

open-angle glaucoma

Anticholinergics Uses

opthalmic exam, motion sickness, pre-operative

Antimetabolite #2 Mexotrexate Se's

oral and GI ulceration, liver damage, bone dep, stomitis, bloddy diarhea, fatigue

Bone-Reabsorption Inhibitors: Biophosphonates Uses

osteoprosis, paget's disease

Antibiotics: Aminoglycosides Side Effects

ototoxicity, nephrotoxicty, nausea, vomiting, diarrhea

Top indications

ovary, lung, colon, and ass cancers

What ABG would you see on DKA?

pH <7.35 HCO3 <15

dysuria

pain difficulty voiding

homans sign

pain in the calf on dorsiflexion of the patient's foot signs of DVT

s/s of urolithiasis

pain, diaphoresis, fever, chills, hematuria

S/S of Gastritis

pain/discomfort in ab hicupping anorexia, N/V

assess syphilis

painless chancre(sore), copper colored rash on palm/soles, mucous membranes

serous fluid

pale yellow and transparent, and of a benign nature

transmission of Hep B- antivirals treatment

parenteral(IV)/sexual

presentation

part of fetus that enters maternal pelvic inlet

clonic

part of seizure where client is jerky

tonic

part of seizure where client is stiff

Billroth I

partial remove (distal one third to one half) of stomach anastomosis with duodenum

mild preeclampsia

past 20th week, 140/90, 2+/3+ proteinuria,assess for this condition

Preop main concern/position of infant with TEF

patent AIRWAY supine/prone with HOB 30degrees

Alcohol Withdrawl assessment

peaks 24-48 hrs after that last drink and may last for 2-3 days - You will see 1. Tremors 2. Insomnia 3. Anxiety 4. Illusions (different from Hallucainations, in Hallucinations, they see something that isn't there, in illusions something is there, ie wallpaper, but instead of seeing butterfiles on it they see snakes and.or bugs) - illusions misinterpret things that 4 in the environment

Troponin

peaks 4-12 hrs; remains elevated for up to 2 weeks

complications with gonorrhea

pelvic inflammatory disease

meds for syphilis

penicillin G IM

Antacids Uses

peptic ulcer, indigestion, reflex esophagitis

What does a sudden cessation of pain with appendicitis indicate?

perforation - ER! High risk of pertonitis

VINCA#2 SE's Vincritstine (oncovin)

perherpial neuritis, loss of reflexes, bone del, gi symptoms

rhythm method of contraception

periodic absence of sex during fertile period of month

Antibiotics: Sulfonamides Side Effects

peripheral neuropathy, crystalluria, photosensitivity, GI upset, stomatitis

Club foot (Talipes Equinovarus):Data/Diagnose

pes: foot equino: heel is elevated like a horse's hoof Data: Plantar flexion or dorsiflexion. Inversion/adduction of forepart of foot. Diagnose: Rigid abnormality of talus bone at birth. Does not involve muscles, nerves, or blood vessels.

activated charcoal

phenobarbital

common medical diagnoses for low phenylalanine diet

phenylketonuria (PKU)

types of mechanical obstruction

physical blockage - hernia, tumors, intussusception (telescoping of bowel) volvulus (twisting of bowel)

striae gravidarum

pink or reddish streaks dueing pregnancy

placenta previa

placenta is implanted in lower uterine segment near or over cervix in 1st or 2nd trimester - spotting, 3rd tri painless bleeding

multiple myeloma

plasma

types of droplet precaution illnesses

pneumonia, meningococcal meningitis, rubella

What are the 3 p's of DM?

polyphagia (increase app) polydipsia (increase thrist) polyuria (increase urination)

on side

position client having a seizure

left side

position for enema

extremities elevated 20*, knees straight, head slightly elevated

positioning client in shock,

lateral right, left, prone, upright, or head down 5 x a day

positions for postrual drainage

late deceleration of 50% of the contractions

positive contraction stress test shows this

PEEP

positive end expiratory pressure maintained at end of expiration to open collapsed alveoli and improve oxegenation

fetal HR by 12 weeks with dopler, fetal HR by auscultation 18-20 weeks, palpate fetal movement, ultrasound visualiztion

positive signs of pregnancy confirmation

cleansing enema to remove barium, xrays

post op barium enema lower gi series

monitor for character and volume of urine, abd distention, urinary frequency, fever, pink urine

post op care for cystoscopy

out of bed after procedure, regular diet

post op care for laparoscoopy

vitals, fever or abd pain, check for hypovolemic shock

post op paracentesis

pressure to site for 20 minutes, pressure dressing, flat bedrest for 24 hours, observe for bleeding and heaturia

post op renal biopsy

vitamin B12 (cyanocobalamin) for life

post test postive schilling test for pernicious anemia

neuro assessment every 15 -30 minutes, position flat for 4-12 hours, fluids, analgesics, drainage

post-op lumbar puncture monitor for

side lying

postion of client having a seizure

common medical diagnoses for clear liquid diets

postoperative; acute vomiting or diarrhea

cardiac rhythm and nerve transmission

potassium plays a roll as a intracellular ion to do these jobs

Skin protection measures for ostomy

pouch opening 1/8 larger than stoma skin barrier under ALL tapes pat dry - DO NOT RUB

autonomic hyperreflexia s/s

pounding headache, profuse sweating (forehead esP, nasal congestion, piloerection, bradycardia, hypertension

abruptio placentae

premature separation of the placenta from cocaine abuse, or HTN causing painful vaginal bleeding,

liquid diet and laxative night before, enema that mornig before exam

prepare client for barium enema lower GI series

NPO after midnight, stool will be light colored after porcedure

prepare client for upper GI series barium swallow

bowel prep, NPO after midnight, check allergies shellfish iodine, chocolate, milk, or eggs, salty flavor during injection, xrays taken intervals

prepare for IV pyelogram

cooled, humidified air, check SaO2 every 4 hours, clean humidity jar and refill with steril water daily

prepare for croupetted or oxygen tent

bowel prep, force fluids, NPO if sedated

prepare for cystoscopy

anesthesia general, foley cath, CO2 introduced

prepare for laparoscopy

semi fowlers position or sitting upright on edge of bed, empty bladder

prepare for paracentesis

xrays, skin marked at lower bole of kidney, position prone and bend at diaphragm, hold breath during needle insertion, NPO

prepare for renal biopsy

radioactive B12 administered

prepare for schilling test

hyperoxygenate, suction 80-100 mm Hg, semi fowlers, lube cath, suction for no more than 10 seconds,

prepare for suction

vitals, shave around insertion, position arms over bed table or lying on side

prepare for thoracentesis

cover client withlight blanket and cap, raise side rails, change linen, check temperature

prepare infant/toddler in a croupetted or oxygen tent

assess fine mist, empty condensation from tubing, keep water container full, 10 lpm 24-100% O2

prepare/teach for tracheostomy collar or T-peice

allow to play with equipment

preschool and school age teaching preop

breech buttocks

presentation of buttocks

complete

presentation of buttocks and legs crossed

cephalic/vertex

presentation of head

breech frank

presentation of hips flexed/knees extended

shoulder

presentation of transverse lie

not allowed in a sodium restricted diet

preserved meats, cheese, fried foods, milk products, canned foods, added salt

Implications for Immune response

prevent by washing hands timely reporting of vs's or symptoms of infection

how is prevention of lyme disease

prevention - by cover exposed area in woods and check for ticks

Immunosuppressants Action

prevents production of T cells and their response to interleukin-2

Immunosuppressants Uses

prevents rejection for transplanted organs

ketogenic diet

prevents seizures; high fat, low carb, mimics effects of fasting and puts body in constant state of ketosis

Nursing managment internal

private room, caution sign, dosimeter filmbadge to measure exposure, no pregnant nurses, rotate staff,

contact precautions

private room, clean gloves, gown,

what is done for airborne precaustions

private room, door closed, standard precautions also

droplet precautions

private room, door open, 3 feet away, face mask, and standard

positive hCG(urine test), uterine enlarged, hegers sign(soft isthmus), chadwicks sign

probable signs of pregnancy are physical signs that the Dr. will assess

lump in the throat, n/v, weak, impending doom

prodromal response to allergen

GBS def

progressive inflamm autoimmune respnse occring in PNS, from compression of nerve roots/periph nerves; demyelination occurs and slows/alters nerve conduction

Meds for glaucoma

prostaglandin agonists, adrenergic agonists, beta blockers, cholinergic agonists, carbonic anhydrase inhibitors (sx- laser trabeculoplasty)

Casting

provides rigid immobilization of the affected area, provides stability and support to help with healing, may be plaster or fiberglass, diminishes skin problems, does not soften when wet Immediate Care: don't cover until dry, handle with palms of hands, don't rest on hard surface, keep above level of heart, check pulses, color and sensation. Watch for blueness, paleness, pain numbness or tingling sensation Intermediate care: When cast is dry pt should be mobilized After cast care: elevate limb

Anticoagulant Coumadin Uses

pulmonary embolism, venous thrombosis, prophylaxis after acute MI

Anticoagulant Heparin Uses

pulmonary embolism, venous thrombosis, prophylaxis after acute MI

xray visualize for kidney, ureters, and bladder

purpose of IV pyelogram

barium placed inrectum with xrays to observe for colon abnormalities

purpose of barium enema lower gi series

visual pelvic cavity in umbilicus incision

purpose of laparoscopy

needle aspiration of fluid in abd cavity to examine ascites

purpose of paracentesis

diagnoses for vitamin B12 deficiency

purpose of schilling test

purulent fluid

pus or infected discharge from wound or incision

kidney infection aka

pyelonephritis

Vagotomty and Pyloroplasty/gastroenterostomy

pyloric stenosis tx estbalishes gastric drainage;involves severing of vagus nerve

Vagotomy & antrectomy

pyloric stenosis tx remove of gastrin-secreting portion of stomach and severing of vagus nerve good for adults w/pud and stenosis

how often do you move ET tube to opposite side of mouth?

q24hrs

tuning fork diagnoses

qualitative hearing loss

blood analysis of TB

quantiFeron- TB gold

audiogram diagnoses

quantitative hearing loss

claustrophobia and any metal implants or pacemakers

question clients before MRI

epidural hematoma

quick onset, short periods of unconsciousness, pupil dilation, weakness in extremities, die quickly

Inserting fake eye

raise upper lid and slip in

pheochromocytoma

rare tumor of adrenal gland tissue. It results in the release of too much epinephrine and norepinephrine, hormones that control heart rate, metabolism, and blood pressure. hypersecretion of catacholamines

recessive or dominate - Pku?

recessive

Antivirals Uses

recurrent HSV, HIV infections

deep partial thickness

red to white burn with blisters, and painful

ATB chemos- Doxorubican(adria) SE's

red urine, nausea, vomtiting, stomatitis, alpoecia, cardiotoxicity, blisters, bone marrow dep

Antithyroid Agents Action

reduce vasularity of thyroid, inbibits release of thyroid into circulation

Bipolar Disorder: Action

reduces catecholamine release

Traction

reduces the fracture, alleviates pain and muscle spasm, prevents or corrects deformities, promotes healing

Antihypertensives: Alpha 1 Adrenergic Blockers Side Effects

reflex tachycardia, orthostac hypotension, nasal congestion

true labor

regular contractions, discomfort radiates from the back, intensity increases with walking, cervix effaced and dilated is true or false labor

position of fetus

relationship of fetal reference point to maternal pelvis

lie

relationship of spine of fetus to spine of mother

Antianginals Action

relaxes smooth muscle, decreases venous return

from 3-7 months

relfexes such as rooting/sucking, palmar, plantar and tonic neck reflex, moro, stepping reflex disappear at what time frame

Billroth II

remove of distal segment of stomach and antrum anastomosis with jejunum

Gastrectomy

remove of stomach and attachement to upper portion of duodenum

Electrolytes Actions

replaces needed electrolytes

unusual cramping, late period, spotting

report these abnormal signs to physician when using IUD

if problem with outflow of peritoneal dialysis do this for client

reposition cleint

balance sign

resonance over left side of abdomin signify spleen bleed

Balance's sign

resonance over spleen w/ pt on left side, indicates spleen rupture

Fatigue

rest, conserve energy

Attention Disorder Agents Side Effects

restlessness, insomnia, tachycardia, palitations

retinopathy of prematurity

retinal detachment, can occur when 02 conc greater than 40% and when used for longer than 48-72 hrs in infants

Descending or sigmoid colostomy (return, oder, drainage, appliance)

return: firm-solid odor: foul drainage: less irritating appliance: varies can be closed or open depending on stool type firm - closed liquid - open

ileostomy (return, oder, drainage, appliance)

return: liquid or semi/liquid oder: slightly odorous drainage: HIGH corrosive appliance: open-ended pouch - worn @ all times unless koch pouch (continent pouch)

where do defib and cardioversion paddles go?

right sternal and over apex of the heart

famliy hx, age >50, menopause after 55, first pregnancy after 30.

risk factors for breast cancer

advanced age, HTN, DM, smoke, obese, elevated lipids, oral contraceptives

risks for brain attack

Naegeles rule of EDB

rist day of LMP- subtract 3 months, add 7 days and one year

sample meal items for low residue diet

roast lamb, buttered rice, sponge cake, "white" processed food

meds for gonorrhea

rocephin with doxycycline, or aqueous penicilin with probenecid

what illnesses use airborne precautions

rubeola(measles), TB, varicella(chicken pox), shingles

what is a risk for a client with Mono

ruptured spleen

fever, swelling, redness, soreness

s/e of DTaP immunization injection

cramps, excess menstrual flow, infection

s/e of IUD

rash, fever, arthritis 1-2 weeks

s/e of MMR

nausea and vaginal infections

s/e of oral contraceptives

embolism

s/s dyspnea, pain, hemoptysis, restless, Low PaO2, high PCO2 (ABG)

low grade fever, CP with radiation, pulmonary edema, restless,

s/s of MI

paralytic ileus complication

s/s of absent bowel sounds, no flatus or stool,

croup

s/s of bark-like cough, dyspnea, cyanosis, inspiratory stridor

transient confusion, decreased LOC, HA

s/s of concussion

atelectasis, pneumonia

s/s of dyspnea, cyanosis, cough, tachycardia, elevated temp, pain on affected side

restless, cyanosis, anxiety, tachycardia, tachypnea

s/s of hypoxia

altered LOC, glascow coma scale, confusion, restless, pupil change, wide pulse pressure

s/s of increased ICP

fluid volume deficit

s/s of rapid weak pulse, hypotension, increased respirations, poor skin tugor, dry mucous membranes, increased Hct and increased urinary specific gravity

syncope, CP, palpitations, abnormal hear sounds, dyspnea, abnormal HR

s/s of rhythm disturbances

cool, clammy skin, cyanosis, decreased LOC, tachycardia, hypotension, shallow rapid respirations, urinary retention

s/s of shock

cyanosis, unable to talk

s/s of upper airway obstruction

hearing, vision, hieight weight, dental, medical, psycho

screeing for school age

PPD, development, sex, affect, breast/testicular, pelvic pap

screening for adolescents (6)

cystic fibrosis carrier, cholesterol, lead poisoning, neuroblastoma, DDST/Denver-II

screening for infant/child - 5

HTN, N/V

se of pitocin

bronchospasm or vagal stimulation

se of suction to watch for

second stage phase 1

second stage of labor watches movment so baby 0-+2 station,contraction 2-3 minutes apart

Antidepressants: Tricyclics Side Effects

sedation, anticholinergic effect, confusion, postural hypotension, urinary retention

Antidiarrheals: Side Effects

sedation, anticholinergic effects

Anticonvulsants Uses

seizures

dehiscence

separation of wound edges

Hormal agent indications

septecmia, and extravastion, ulceration afrter 48h

distributive shock

septic shock, toxic shock, anaphylaxis shock, neural induced loss of vascular tone

Nursing condsiderations

septicemia and extravation, redness, ulceration after 48 hours

protein malnutrtion

serum albumin test is to detect this

classic s/s of hypoglycemia

shakiness/tremor irritability nervousness

maternal hypotension, respiratory depression, fetal distress,

side effects to spinal anesthesia to mother

flail chest

sign of chest trauma affected side goes down during inspriation and up during expiration

hypotension (vasodilation), tachycardia, dysrhythmia

signs of allergic reaction in circulation

bounding pulse, HTN, dyspnea, rales/crackles, peripheral edema, decreased Hct and decreased BUN

signs of fluid volume overload

closed method of wound care

silvadene is used for these types of skin care for burns

levin NG tube

single lumen tube used for decompression or tube feeding

cantor, miller-abbott, harris tubes

single or double lumen intestinal NG with mercury filled balloon with suction

Instructions for colostomy irrigation

sit upright performed after a meal, SAME TIME each day 500-1500mL lukewarm water insert cath 3inches water flows in over 5-10mins, allow 10-15mins for return sleeve in place while pt moves around 30-45mins clean with soap water and pat dry

neutropenic precautions(prevent infection with immunosuppressed patients)

skin integrity qh8, breath sounds, temp q4 101 report, no fresh flowers! or standing water

Antidiarrheals: Actions

slows peristalsis, increases tone of sphincters

water balance,

sodium main job as an extracellular ion

not allowed in a high protein diet

soft drinks, "junk" food

keofeed/dobhoff

soft silicone NG for long term feedings

what other test confirms TB

sputum culture

care at home for croup syndromes: acute epiglottis/laryngotracheobronchitis

steamy shower, sudden exposure to cold air, sleep w/ cool humidified air

-one

steroids

Glucocorticoids Action

stimulates formation of glucose, alters immune response

Hypoglycemic Agent: Action

stimulates liver to change glycogen to glucose

Internal mouth care

stomatisis-5-4 days after s's's erythema, bleeding, ulcers oral rinse ns or sof tb avoid hot topical antifungals and anesthetics

Antineoplastic: Vinca Alkaloids Side Effects

stomatitis, alopecia, loss of deep tendon reflexes, bone marrow suppression

Antibiotics: Penicillins Side Effect

stomatitis, diarrhea, allergic reactions, renal and hepatic changes

what raises risk for reoccurance of herpes

stress, infection, menses

sucking chest wound

sucking sound with respiration, pain, decreased breath sounds and anxiety

Antidepressants: SSRIs Nursing Considerations

suicide precautions takes 4 weeks to fully work take in am turn urine pink

open method of wound care

sulfamylon is used for these types of skin care for burns

Antitussive Agents Actions

suppress cough reflex by inhibiting cough reflex in medulla, decrease viscosity of secretions

Open reduction

surgical dissection and exposure of the fracture for reduction and alignment

Glucocorticoids Side Effects

susceptible to infection and masks infection, insomnia, hypoglycemia, hypokalemia, psychoses, depression, stunted growth

Bouchard's nodes

swelling at the proximal interphalangeal joints (PIP) in osteoarthritis involving the hands

Bronchodilators Side Effects

tachycardia, dysrhythmias, palpitations, anticholinergic effects

Antidiabetic Agents: Nursing Considerations

take before breakfast Monitor glucose levels avoid alcohol

if meds cause nausea tell client to take TB meds at night

take meds at night

when you remember

take oral contraceptives same time each day but if miss one pill take it when

GBS recovery

takes months-year. Progression period of disease? 10 days

check cmc, monitor serum calcium, non-steroidal anti estrogen

tamoxifen-hormonal

chvosteks sign of hypocalcemia

tap on the side of the face and notice a musle spasm reaction in the cheek

Chvostek's sign

tapping over the facial nerve elicits abnormal muscle contraction; associated with hypocalcemia

monitor rate and rhythm, check for bleeding and infection, rest, hand scanner at airport, avoid strong magnets

teach and implement for pacemaker cleints

milk tube in direction of drainage and encourage patient tochange positions

teach chest tube to client

vitals, pulses, sensation, bleeding at insertion site and bedrest for 6-8 hours with insertion siste straight

teach client post op of cardia cath

remove jewlery, may experience nausea, flushing warmth, salty taste from dye

teach client pre angiography

NPO for 4-6 hours pre test, table will be moved during test

teach client pre myelogram

hold breath midexpiration and use of fluoroscopy with sitting over table or lying on side

teach client preparation of lung biopsy

NPO 6-12 hours, remove dentures, sore throat expected post op,

teach client these before bronchoscopy

flushed warm face and metallic taste during injection

teach experience of CT scan

arms at side, arms above, and hands on hips

teach inspection of breast exam position

relaxed, offer both breasts 5 min each, most areola into infant mouth, break suction by inserting finger

teach mother breast feeding techniques

frequent feeding every 30 minutes to every 3 hours, empty the breast with feeding, alternate starting breast, empty and save

teach mother to care for breast engorgment during brestfeeding

fluids, laxatives to prevent constipation, stool is white from barium

teach post op upper gi series barium swallow

NPO 6 hours prior, give sedative, hold breath during biopsy for 5-10 seconds

teach pre liver biopsy

expect tingling sensation with injection of anesthetic

teach the client this sensation when getting alocal anesthetic for thoracentesis

inhale, hold breath for 3-5 seconds, seal around mouthpiece, sit in semi-fowlers, max out respiration and secretions to prevent atelectasis

technique for incentive spirometer done 10 breaths per hour while awake

dont cross legs or elevate knees gatch

tell client to avoid these two positions

common medical diagnoses for low residue diet

temporary GI/elimination problems

non-stress test

test during pregnancy of mother eating a snack and recording FHR accelerations of 15 bpm to normal

cholesterol

test evaluates tendency for atherosclerosis, fasting

alpha-fetal protein test

test that is used to predict neural tube defects such as spina bifida during weeks 16-18 weeks of pregnancy

KUB, IVP, xray

tests that diagnose BPH

IM, anteroir or lateral thigh, repeat every 10 years

tetanus/diptheria TD booster is givne where and how often

thin greenish brown 3rd day

the first two days the newborn will pass meconium black tarry stool but the 3rd day

the dryer they are or dehydrated they are

the higher the Hct number and specific gravity this is what fluid imbalance

rubra - bloody

the lochia discharge from mother from day 1-3 after birth is this

during the menstrual period, check for string

the physician will insert IUD during this time of month for femal

T

thickening of or a lump in the breast or elsewhere

TORCH

this is the pneumonic for possible infections for pregnant mother and fetus

vitamin E and infant eyes...

thought to affect tissue response to 02

duration

time in seconds from beginning to end of contraction

icepacks, tight fitting bra

tips for breast care for non-breast feeding mothers

purpose of renal diet

to keep protein, potassium, and sodium low

purpose of sodium restricted diet

to lower body water and promote excretion

purpose of clear liquid diet

to maintain fluid balance

purpose of high roughage, high fiber diet

to maximize bulk in stools

purpose of low residue diet

to minimize intestinal activity

purpose of high protein diet

to re-establish anabolism to raise albumin levels

purpose of low fat, cholesterol restricted diet

to reduce calories from fat & minimize cholesterol intake

simple directions

toddler teaching preop

arm is extended wherehead is turned

tonic neck reflex is this

Antibiotics: Cephalosporins Uses

tonsillitis, otitis media, peri-operative prophylaxis, meningitis

Nutriton

tpn, monitor for anorexia

Hormonal Agent-tamoxifen

transient fall in wbc or platelets, hypercalcmeia, bone pain

trhobolytic therapy(streptokinase, t-PA), bed rest, beta blockers, morphine, dysrhythmics, anticoagulants

treatment for MI includes

phototherapy(blue light), exchange transfusion, fluids, cover eyes and genitals

treatment for hemolytic jaundice

cardiac monitor, meds, defib, pacemaker

treatment for rhythm disturbances

O2, BP > 90 mmHg, CVP, I/O, isotonic solution all to increase tissue perfusion, body temp maintained, ABG,

treatment for shock

steamy shower, sudden exposure to cold air, cool, humidified air

treatment of croup toddler

sengstaken blakemore

triple lumen NG tube used for esophageal varices

how often oral hygiene for mech vent?

twice shift

surgery within past two weeks, pregnancy

two contraindications for throbolytic therapy for an MI

antiarrythmics, antilipids

two meds for rhythm disturbances

type 1 dm @ risk for _____ type 2 dm @ risk for ____

type 1 - diabetic ketoacidosis type 2: HHNK

Halo Fixation Device (vest)

type of skeletal traction Purpose: Provides immobilization of cervical spine; Pins are used to maintain traction Treatment: --Maintain sterile technique when cleansing area around pins (1-2 times/day)

streptokinase, t-PA, beta blockers, morphine, antidysrhythmics, anticoagulants

types of meds for MI

diuretics, corticosteroids, anticonvulsants

types of meds to help decrease ICP

Antibiotics: Sulfonamides Uses

ulcerative colitis, Crohn's, otitis media, UTIs

H2-Receptor Blockers Uses

ulcers, gastroesophageal reflux

aphasia

unable to speak or use of language

urinary retention

unable to void 8-12 hours post op with bladder distention

sample meal items for renal diet

unsalted vegetables, white rice,canned fruits, sweets

Unsealed internal radation

unsealed liquide, instilled in body cavity, iodine all body fluids effected greatest danger for fluid in first 24-96 hrs

U

unsual bleeding or discharge from any orfice

diptheria

upper respiratory bacterial disease

cystitis assessment

urgency, frequency, burning, cloudy, strong odor urine

what indicates that diabetic control has deteriorated and body has started to break down stored fat for energy

urine ketones

kidney stones or renal stones aka

urolithiasis

Internal fixation

use of metal screws, plates, nails, and pins to stabilize reduced fracture

Chemo 4 hormonal action testcaolane) androgen

used for palliative care in advance breast cancer

ALkylating Agent Nursing considerations

used whith other chemo drugs, check hematopoetic function weekly. Encourage fluids, 10-12 glasses a day

isometric exercise

useful for building strength, involves a held contraction against an immovable base, alternate contraction & relaxation of muscle, maintains strength of muscle when joint is immobilized

preventing meningitis

vaccine 65+ w/ chronic diseases, revaccinate in 5 years; hib vaccine for infants

Correlated with chemical

vaginal cancer acute myelogenous leukemia non-hodgkins lymphoma multiple myeloma lung cancer

off baseline

variablilty of FHR is defined as

Antiplatelet Agents Uses

venous thrombosis, PE

xray only way, aspirate for gastric contents,

verify NG placement

NPO 12 hours before cardiac catheter, sign permit, empty bladder, pulses

verify client before cardia catheter

turn on left side

vertigo:vena cava syndrome and implement care during pregnancy

vibrating pressure is applied to chest as person exhales

vibration technique for drainage

#5 VInca alkaloid meds

vinblastine(velban) vincristine (onocovin)

strabismus s/s, trmt

visible deviation of eye, diplopia, child tilts head/squints to focus. Occlude unaffected eye to strenghten weaker eye

assess for BPH

voiding difficulty, frequent, urgent, hesitant, blood in urine, nocturia

Antidiarrheals: Uses

vomiting

warm v cool compresses for eye

w/ contusions cold compress, w/ eye infection/inflammation warm compresses

purified protein durivative

waht does PPD stand for

Preop ostomy diet

week before surgery - high calorie, high protein, high carbs, low-res (fiber) diet evening before - laxatives/enemias / NPO after midnight

implement peritoneal dialysis

weight before and after, BP, breath sounds, sterile technique

15% legs and 9.5% arm

what % of child infant is burned on arms and legs

19% head and 32% torso

what % of child/infant bursn to head and torso

low pressure and low exhaled volume

what alarms are set on a ventilator

escymia and electrolyte imbalance

what are causes for Ventricular distrubances

bladder and bowel distention, pain, or tactile over stimulation

what are causes to autonomic hyperreflexia from spinal cord injury

febrile illness, altered immune system, allergic response, recent passive immunity(blood transfusion)

what are contraindications for immunizations

long term benefits, accept regression and provide privacy

what are good tips for adolescent before procedure

allow questions, explain why, handle equipment

what are good tips for school age child

do not disconnect cathter from drainage system, don't remove more than 700 ml of urine at one time

what are not to be done with a cathater system

younger than 18 or 35 yo or older, poor nutrition, diabetes, renal or vascular disease, family hx, large fetus, proteinuria

what are risk for PIH(pregnancy induced hypertension)

UTI and toxic shock syndrome

what are risks for the use of diaphragm

irregular bleeding, nausea, skin changes

what are s/e of norplant

vomitting, diarrhea, gastric suction, diuretics, steroids, inadequate intake

what are some causes of hypokalemia

pneumothorax, air embolism, infection

what are some complications of CVP

distraction, simple explanations

what are some tips for toddlers before procedures

syphilis, strp, HEP A or HEP B, Aids

what are the OTHER infections for TORCH

head engaged, ripe cervix, mature vertex/head presentation

what are the indications to induce labor

<195 hour 1, <165 hour 2, <145 hour 3

what are the normal findings of all three hours of glucose tolerance test.

puppets, dolls, demonstrate equipment, eye level

what are tips for pre-schooler

tranquilizers, stimulants (caffiene and cigarettes) withheld

what are withheld from the client pre EEG

low Hct and low hCG levels

what blood tests will confirm ectopic pregnancy

pull up to stand with help

what can 10 month old do for movement

change masks, tubing, mouthpieces daily

what can be done to avoid infection on O2 therapy

retinopathy of prematurity

what can happen to infant if oxygen toxicity occurs

low concentrations of O2

what can prevent retinopathy of prematurity for infant

internal radiation implants, hysterectomy

what care for endometrial cancer

fetus Rh+ and mother is Rh-.

what condition is mother and fetus for mother to receive Rhogam

diabetes, postmaturity, PIH, fetal jeopardy,

what conditions of mother/fetus may induction of labor commence

O occiput, S sacrum

what do the O or S stand for position

evaluates renal function, affected by protein intake, tissue breakdown, fluid volume changes

what does BUN detect and how is the number affected

Haemophilus Influenza type B (Hib), 2,4,6, 12-15 months (4 injections)

what does Hib mean and when are the injections given

transurethral resection prostate

what does TURP stand for

liver function and bone function 30-150 units/L

what does alkaline phosphatase check which organ

specific arterial areas

what does angiography assess

FSH

what does oral contraceptives inhibit release of what hormone

avoid hypoxia and trauma to airway

what does suctioning procedure try to avoid

erythromycin/tetracycline/silver nitrate

what eye prophylactic medication for newborn to prevent infection in eyes

LR rapid infusion first 8 hours

what fluid is forced for burn patients

candy, nuts, seeds, or cut up hot dogs

what foods to avoid for infant

elevated to all WBC, ESR, CK-MB and troponin

what four blood tests prove MI

ET tube first then suction mouth

what gets suctioned first then second mouth and ETT tube

cut off contaminated tip, insert sterile connector and immerse end in 2 cm of sterile water and reinsert

what happens if tube becomes disconnected from drainage system

apply dressing tented on one side to allow for air to escape

what happens if tube is dislodged from client

gravity helps position tube

what helps position intestinal NG tube

hypovolemia

what if CVP is below < 3 cmH2O

right side of heart to manage fluid and cardiac pumping volume

what is CVP checking for

effective for 5 years, surgical insertion and removal

what is Norplant contraceptive

no, so give choices

what is a 2 year old (initiative) common to say and what is a good tip for parent.

if the head is too big such as CPD

what is a contraindication to induce labor

vitamin K IM

what is administered IM to avoid excess bleeding

diarrhea, constipation, tarry stools

what is also assessed when client on a ventilator beside respiratory status

muscle relaxant vasodilator for HTN

what is apresoline med

incision, drainage, amount and character, drains,

what is assessed at the surgical sight post op

dont squeeze eye after eye drops are placed

what is avoided when giving eye drops

clear thin and slippery

what is cervical mucus look like during ovulation

blue color of cervix

what is chadwick sign of pregnancy

temperature and volume

what is checked for humidified O2 on ventilator

hold breath

what is client instructed to do when tubing of CVP is inserted, withdrawn or tubing changed

vitals x 15 min, LOC, I/O, CVP, potassium levels, respiratory care

what is closely monitored post-op

after contraction starts to subside FHR decreases

what is considered late deceleration

between 20-37 weeks

what is considered pre-term labor

dont give asprin

what is contraindicated after DTaP injection

termination of pregnancy before viable or 20 weeks/500 g

what is definition of abortions

difficult to measure amount of O2 delivered

what is difficult to monitor for a croupetteor oxygen tent

stop anesthesia, muscle relaxant

what is done if client experiences malignant hyperthermia when receiving anesthesia

loss of independence and body image disturbance, involve in procedure, understanding and strengths

what is expected behavior of adolescence pre surgery

experience heat, palpitations, desire to cough when dye is injected

what is explained experience for acrdiac catheter

loss of control and allow choices

what is fear before surgery of a school age child and what is good implementation

check fetal heart tones, and check for prolapsed cord

what is first thing to do when membranes are ruptured during labor

head elevated 8-16 hours, neuro assessed every 2-4 hours, fluids, analgesics

what is given and monitored for myelogram

IV fluids fast to prevent maternal hypotension

what is given to mother before a regional lumbar epidural block is given

dont heat breast milk in microwave

what is good tip for reheating breastmilk

risk for bleeding

what is high risk for a liver biopsy

dry crackers in morning/ small frequent meals

what is implement for morning sickness

vitals and I/O and teaching to reduce risks

what is implementation monitor and teaching

sulfa drugs or ampicillin

what is medications used for pregnant mother with UTI

minimum 5Lpm

what is minimum Lpm of O2 for a face mask

allergy response and encourage fluids to flush dye

what is monitored and encouraged post CT scan

monitor for dyspnea

what is monitored for post test of pulmonary function test

contraceptive foam

what is needed if the condom is broken during sex

no late decelerations of 3 contractions in ten-minutes

what is negative contraction stress test result show

65/40 in arm or calf

what is normal BP of newborn

FHR acceleration

what is normal FHR response during mother contraction

cerivcal mucus is normally thick, cloudy and sticky

what is normal cervical mucus shown during nonfertile time of month

fluid fluctuates with respirations

what is normal sign of fluid fluxuation of CVP manometer

24-28 pounds

what is normal weight gain for pregnant client full term

three middle fingers to palpate, circular motion while lying down

what is part of hand is used to inspect breasts

check hemorrhage or respiratory distress, xrays, resume diet

what is post op care for colonoscopy

striking of chest wall with cupped hands over area of secretion to facilitate drainage

what is puprose of percussing chest

used with angiography to introduce catheter into heart chambers for pressures and ventricular function

what is purpose of cardiac catheter

relaxes smooth muscle for the ease of urinating

what is purpose of flomax

lung tissue removal for culture or cytology

what is purpose of lung biopsy

obtain specimen, relieve lung compression,

what is purpose of thoracentesis

prevent aspiration of fluids

what is purpose of trach tube cuff

determine esophagus patency and size, gastric walls pyloric valve and rate of passage into small bowel

what is purpose of upper GI series barium swallow

sterile dressing applied

what is put over incision after lung biopsy

neurogenic bladder

what is reason for using intermittent self-catheterization

provides fixed concentration and high humidity

what is significant of venturimasks

hyperventilate during test, kept awake night before test, eating is allowed

what is taught pre EEG test

encourage fluids, rinse mouth out with water, dont brush teeth, eat or use mouthwash

what is taught to client before taking a sputum analysis

turn, cough, deep breath, pain meds, incentive spirometer, PCA, teach mobility asap

what is taught to client post op unless dr. stated restrictions

allow rest, check hemorrhage, fluids

what is taught to client post sigmoidoscopy

sit or lie on side, NPO until gag relfex returns to avoid aspiration, monitor for respiratory difficulties

what is taught to client postop bronchoscopy

laxative night before, enema or suppository am before and NPO midnight

what is taught to client pre sigmoidoscopy

NPO 8 hours prior, numbing throat

what is taught to client pre stomach/esophagus endoscopy

no smoking 4 hours prior to exam and bronchodilators may be restricted until after test

what is taught to client preparing for a pulmonary functio test

head injury to the pituitary gland that regulates the diuretic hormone

what is the cause for diabetes insipidus or decreased ADH

pulmonary complication so Ang I is not converted to Ang II so retains water

what is the cause of the SIADH

prevents implantation of fertilized egg

what is the puropose of the contraceptive IUD intrauterine device

prevent obstruction and remove sediment

what is the purpose of catheter irrigation

bed rest, air mattress, restrict movements, foley catheter

what is told to cleint with internal radiation implants for endometrial cancer

full bladder

what is told to client before ultrasound to assist clarity of image

prevent pregnancy for 3 months

what is told to female client before a live attenuated rubella vaccine is given

clear liquid diet 24-72 hours prior, cathartic(go lightly) in evening for 2 days prior, enema am before exam

what is toldto client prepare for colonoscopy

visualizes spnal column and subarachnoid space

what is use of myelogram

pressure garments

what is used to prevent scarring from burn victim

tripled weight

what is weight of child at 12 months

phenothizines, CNS depressants and stimulants held for 48 hours pre

what is withheld form client pre myelogram

pitressin to conserve water

what med is administered for diabetes insipidus

oral hypoglycemic meds due to cause hypoglycemia in fetus

what med is avoided for GDM.

apresoline IV slowly

what med is given for autonomic hyperreflexia

calcium gluconate slow IV

what med is given iv for hypocalcemia

antimicrobial phrophylaxis antibiotic

what med is given postop cystoscopy

maalox (antacid)

what med is high in magnesium

terbutaline used to delay preterm labor

what med is used to delay preterm labor and is not used to stop preterm labor

kayexalate, calcium gluconate, sodium bicarb IV, diuretics,

what meds are used to treat hyperkalemia

allergy to shellfish or iodine

what must ask client for allergies pre CT scan

IV fluids

what must be given to mother when receiving a spinal anesthesia

parathyroid hormone and vitamin D

what organ regulates calcium

fundus from slightly tense to firm

what part of mother are contractions strength measured

supine, lateral with upper arms elevated

what position for client before liver biopsy

dorsal recumbent or sims position

what position is catheter of woman done

semi-fowlers or side lying

what position is contraction stress test for pregnant mother at 28 weeks

lateral recumbent fetal position

what position should client be in for a lumbar puncture

denver development screening test

what screening test for developmental from birth to 6 years

no vaginal or rectal exam

what should be intervened if Dr. performs these procedures on a client with placenta previa

thumb and forefinger

what should be used to palpate testicles

6-15 mg/day

what sodium amount diet should be given to fluid volume overload client

high protein, high carbohydrate, high sodium, low potassium diet

what specific diet is made for addisons disease

GTT normal 60-110 mg/dl

what test is diagnostic for diabetes mellits

platelet count

what test is for hemorrhagic disease

PT/INR

what test monitors coumadin therapy 9.5-12 seconds

PTT

what test monitors heparin therapy 20-45 seconds

tidal volume, RR, pO2(fraction of inspired O2), need for suction, mouth care

what to assess for a client on a ventilator

dressing, drainage, breath sounds, vitals

what to check for post-op thoracentesis

dimpling, discharge, or any other changes

what to look for in breast exam

NPO until gag reflex returns, check blood in vomit, respiratory distress and sore throat for 3 days

what to moniotr for postop stomach/esophagus endoscopy

bedrest 24 hours, vitals, clotting times, platelets, Hct, abd pain

what to monitor for after liver biopsy

hematoma, vitals, skin temp and color, sensation

what to monitor post angiography

separation, regression, difficult separation

what to teach parent pre-op about toddler going in for surgery

shoulder back pain from CO2 and will decrease

what to warn client post op laprascopy

silver nitrate/ silvadine

what topical ointment is used for burn victim

glucosuria, proteinuria

what two abnormal urine specimens are risk for GDM

aseptic technique

what type fo technique is used to changed post op dressing change

humidified air

what type of O2 is administered for trach collar.

hypotension

what type of blood pressure assessed for tenion pneumothorax

acid-ash diet- meat, eggs, fish, cereal, no milk or cheese

what type of diet for a preop BPH surgery

high protein, low carbohydrate, low calorie, high potassium low sodium diet

what type of diet is used for cushings syndrome

high fat low carbs

what type of diet is used for seizure client

high calorie, high carbohydrate, high protien diet

what type of diet is used to promote healing of burn victim

antipyretics

what type of meds are given for croup

sedatives or analgesics

what type of meds for a lung biopsy

clean technique

what type of risk technique is intermittent self-cathterization

aseptic technique

what type of sterile technique is followed during surgery

ischemic stroke within

what type of stroke uses thrombolytic therapy

heparin syringe

what type of syrnge is used for ABG Allen test

pacemaker

what type of unit is used to treat heart blocks of rate of 20-40 blpm

ampicillin, polymyxin and cephalothin

what types of antibiotics are used for septic shock

deep breathing, leg exercises, incentive spirometer

what types of teaching are reviewed before surgery for post-op

vitamin k,

what vitamin is administered to begin normal blood clotting in newborn

B, C, and iron

what vitamins are prescribed for burn victim

water jelly around the nares every 3-4 hours

whatcan beplaced around nares if on NC

6 months

when after birth is the birth weight doubled

use sterile container, collect in early am

when and how is sputum collected

warm shower once a month

when and where should a testicular self exam be done

12-15 months, 4-6 years, (2)

when are MMR inections

1-3 months

when can a cleft palate be fixed

until lochia flow is ceased or episiotomy is healed

when can sex reoccur after postpartum

bleeding ceases

when can sex resume after tubal ligation

no tub baths until cord falls off

when can the baby get their first bath

1-2 weeks

when does the umbilical cord fall off newborn

Kernig's

when hip flexed to 90, complete extension of knee is restricted/painful

16 weeks

when is an amniocentesis done through abdomen to the amniotic sac to detect genetic disorder

checked at 1-5 minutes

when is apgar score checked after delivery of newborn

3-5 days postop

when is infection anticipated post-op

2,4,6,12-15 months (4)

when is pneumococcal vaccine given

38-42 weeks

when is pregnancy at the "term"

drop in basal body temp before ovulation and slight rise after ovulation

when is the fertile period for the client during the month

mechanical vent, during and after eating and tube feeding, presence of oral secretions

when is the trach tube cuff inflated

valsalva maneuver and clamp chest tube, remove quickly, apply occlusive dressing

when removing chest tube have pt. do this before removal

When do you instruct the pt to change appliance?

when seal breaks or when 1/3- 1/4 full

schedule after menstrual period

when should a mammography be done for breast exam

one week after onset of menstrual period or designated day

when should breast self exam occur in the month

after 50

when should fecal blood occult test be done

IPV 2,4,6-18 months, 4-6 years (4)

when should inactivated poliovirus immunization be given

contractions last longer than 90 seconds

when should pitocin be stopped.

q 6- 8 hours each part of day

when should self-cathterization be accomplished

every 24 hours

when should the diaphragm be removed

longer than 90 seconds

when should the duration of a contraction be reported

less than two minutes apart

when should the frequency of contractions be reported

moro reflex

when the newborn loses the feeling of support by extending the arms and fingers outward

20 weeks

when would fundus of pregnant client be at the umbilicus

central line threaded into right atrium

where is CVP placed

SQ anterior/lateral thigh

where is MMR given

common bile duct 500-1000 ml/day, keep below waist, gall bladder surgery

where is a T-tube drain located and used for and checked for

IM anterior/lateral thigh

where should DTaP be injected

drainage port only and clamp below port

where should a urine sample be collected with a catheter

brachial pulse

where to check pulse of an infant in arrest

above T6

where would autonomic hyperreflexia occur from a spinal cord injury

anterior fontanelle

which fontanelle closes last posterior or anterior

fenestrated tube

which trach tube is designed for client to talk

not allowed in a high roughage, high fiber diet

white bread, pies and cakes from white flour, "white" processed foods

vernix caseosa

white film on parts of the newborn that will eventually fall off

involve family and help reinforce teaching

who can help in preop teaching for children

health care provider

who fits the diaphragm for the client

not allowed in a low residue diet

whole wheat, corn, bran

Ihair

wig

nurses responsibility for patient bill of rights of informed consent

witness signature and consent attached to chart

formula feeding

yellow to light brown stool is shown from this type of feeding

DTaP, IPV, MMR and tine

you can give these 4 immunizations at the same time

Russell's Traction

"Pulls" contracted muscles; elevate foot of bed with shock blocks to provide countertraction; sling can be loosened for skin care; check popliteal pulse. Place pillows under lower leg. Make sure heel is off the bed. Must not turn from waist down. Lift patient, not leg, to provide assistance.

Antiparkinson Agents Med Names

(-dopa) Artane, Cogentin, L-Dopa, Parlodel, Sinemet

Chemo 4- hormonal agents actions (tamofifen) (antiestrogen)

(competes with estrogen to bind at estrogen receptor sites on malignant cells)

Paget's Disease

*Breakdown of bone tissue* Data:Pain, Bowed legs/decreased height, Shortened trunk with long-appearing arms, Enlarged skull, labored/waddling gait, Kyphosis (hump back), Pathologic fractures Diagnose: Unknown etiology, excessive bone resorption (loss), Occurs more in older adults. Plan: 1. Administer analgesics, 2. Encourage rest 3. Prevent Pathological Fractures 4. Administer meds: Calcitonin (Miacalcin), biphosphonates ex. Alendronate (Fosamax); pamidronate (Aredia)

Neuromuscular disorder: Cerebral Palsy:S/Sx

*a loss or deficiency of motor control with involuntary spasms caused by permanent brain damage present at birth; poor control over muscles due to brain damage (cord wrapped around neck) Athetosis (twisting movements), spasticity, rigidity, ataxia, atonicity; repetitive, involuntary, slow, gross movements. Neonate:cannot hold head up, feeble cry, inablility to feed, body noticeably arched or limp. Infant: failure-to-thrive syndrome. Toddler/preschooler: mental retardation, delayed physical development.

Sx of Developmental Dysplasia of the Hip (DDH)

*acetabulum unable to hold head of femur* 1. Uneven gluteal folds an thigh creases (deeper on affected side). 2. Limited abduction of hip with pain. 3. Ortolani's sign (seen in infants <4 weeks old):Place infant on back, leg flexed. Click sound heard when affected hip is moved to abduction. 4. Shortened limb on affected side in older infant and child. 5. Delays in walking; limp, lordosis, and waddling gait with older child.

Neuromuscular disorder: Muscular Dystrophy: S/Sx

*any of several hereditary diseases of the muscular system characterized by weakness and wasting of skeletal muscles; degenerative disease- slowly takes away use of muscles (legs first)* Muscle weakness, lordosis/scoliosis, waddling gait, joint contractures. Stumbling and falling.

second stage phase 2

+2-+4 station, contractions 2-2.5 min apart, increase dark red bloody show, increased urgency to bear down

second stage phase 3

+4 station to birth, contraction 1-2 minutes apart, fetal head visible, urgency to bear down increased, dilvery of fetus

Complications from Fractures

- Fat Emboli - Delayed Union - Malunion - Nonunion - Sepsis - Compartment syndrome

Body response to pain

- Increase pulse, respirations - Pupil dilation - Increased perspiration and muscle tension - Altered GI motility

Complications of Fractures

--Fat emboli- (long bones) fat globules move into bloodstream. --Hemorrhage --Delayed union- healing is slowed; caused by infection or distraction of fractured fragments; Bone pain will increase --Malunion- Improper alignment of fractured fragments. May develop with premature weight-bearing --Nonunion-Healing has not occurred 4-6 months after fracture. Why? Insufficient blood supply, repetitive stress on fracture site, infection, inadequate internal fixation --Sepsis --Compartment syndrome: High pressure within a muscle compartment of an extremity compromises circulation. Pressure may be internal (bleeding) or external (casts). If left untreated neuromuscular damage occurs within 4-6hrs; Limb can become permanently useless within 24-48 hrs --Peripheral nerve damage

Beta Blockers

-lol can cause bronchspasms airway is a consideration

Antihypertensives: Beta Blockers Med Names

-lol (beats)

Antibiotics: Aminoglycosides

-mycin

Antihypertensives: Alpha 1 Adrenergic Blockers Med Names

-osin

Benzodiazepines

-pams

Antihypertensives: Calcium Channel Blockers Med Names

-pine, Cardizem

Antihypertensives: Ace Inhibitors Med Names

-pril (think arteries)

Antihypertensives: Angiotensin II Receptor Blockers Med Names

-sartan

Caution

...

ET 4- Classifications

...

Nursing Implications for All SE's

...

Nursing management #1 Chemotherapy

...

Insulin: Fast Acting Onset

.5-1h

Insulin: Combination Onset

.5h

phase one of first stage of labor(latent)

0-3 cm dilation, contraction 10-30 seconds/5-30 minutes apart, mild to moderate intensity

Digoxin Therapeutic Levels

0.5-2

normal creatinine levels

0.7-1.4 mg/dl

how often breaths given during CPR w/ advanced airway

1 breath q6-8 secs (8-10 breaths/minute)

What meds will a pt be on for ulcers? (5)

1) Antacids (maalox) admin 1 hr before meals or 2hrs AFTER meals 2) Histamine Recep site antagonists (Tagamet) take WITH FOOD 3) Anticholinergics (Pro-Banthine) 30 mins before meals 4) Cytoprotective agents (Carafate) 1 hr before meals 5) Protein Pump inhibitors (Prilosec)

What is the proper nursing care for a client in Buck's traction?

1) The nurse removes the foam boot 3 times per day to inspect the skin. 2) The staff turns the client to the unaffected side. 3) The nurse asks the client to dorsiflex the foot on the affected leg. (assessment of the perineal nerve; weakness of dorsiflexion may indicate pressure on the nerve) 4) The staff elevates the foot of the client's bed. (provides countertraction) 5) Back care should be provided Q2H to prevent pressure sores.

Self-monitoring BG teaching (4)

1) check pts eyesight - ensures able to draw up amt 2) calibrate monitor 3) check exp date of test strips 4) keep log book 5) check skin/feet talking

Sick Day Rules: 4

1) continue taking med 2) check BG & urine ketones q-3-4hrs 3) vomiting, diarrhea, or fever - contact dr 4) liquies intake .5-1hr (cola, broth, gatorade)

Name 8 risk factors of DM

1) parents/siblings w/dm 2) Obesity (20% of ideal body wt) 3) African, Hispanic, Native, Asian 4) >45yrs 5) prev imp fasting glucose 6) HTN 7) HDL <35 / triglyceride >250 8) hx of GDM or baby >9lbs

After post op of ulcer surgery, what would you teach about dumping syndrome? (6)

1) restrict fluids w/meals (1hr before/after) 2) Avoid salt, sugar, milk 3) HIGH protein, HIGH fat, HIGH fiber, LOW CARBS!! 4) small freq meals with ZERO fluid during 5) lie down 20-30mins after eating 6) Antispasmotic drugs

normal urine excreted/day

1,000-2,000 ml day

what type of drainage may you see in the ostomy 1-2 days after?

1-2 days, just mucus or serosanguneous drainage 3-6days post op: function works

Stinulant Abuse - symptoms of withdrawal

1. Apathy 2. Long periods of sleep 3. Irritability 4. Depression 5. Disorientation

Preop plan for Herniated Intervertebral Disk

1. Apply moist heat 2. Put Pt in Fowler's position with moderate hip and knee flexion. 3. Use firm mattress, bedboard, or floor for back support. 4. Isometric exercises for ABD muscle. 5. Daily exercise program. 6. Assist with exercise initiated in PT. 7. Medications:Muscle relaxants, NSAIDs, analgesics. 8. Traction: separates vertebrae to relieve pressure on nerve 9. TENS (Transcutaneous electrical neruve stimulations) 10. Log Roll when moving

Plan for Sleep Apnea Syndrome

1. Avoid alcohol and medications that depress upper airway. 2. Weight-reduction diet and activity 3. For severe cases, if client is hypoxic and hypercapnic (too much carbon dioxide), will use continusous positive airway pressure (CPAP) or bilevel positive airway pressure (BIPAP) with additional oxygen. *Air pushed thru nose or mouth into lungs to open up airway and keep them breathing. 4. Position-fizing devices used to prevent tongue obstruction and subluxation of neck 5. Surgery to correct obstruction 6. Low-flow oxygen 7. Tracheostomy if life-threatening dysrhythmias are present; unplugged only during sleep

Korsakoff's Psychosis implementation

1. Balanced diet 2. Thiamine 3. Abstinance from alcohol

Wernicke's Syndrome Assessment

1. Confusion 2. Diplopia, Nystagmus 3. Ataxia 4. Apathy

Osteoporosis: Plan/Tx

1. Diet high in Ca+, protein, and Vit D. 2. Encourage weight-bearing on the long bones (walking) 3. Fall Prevention 4. Physiotherapy 5. Teach about Medications 6. Safety precautions to prevent pathological fractures (from weakened bones) -Use back brace or splint for support -Use bedboards or hard mattress 7. Medications: calcitonin (Miacalcin), biphosphonates (ex. alendronate), selective receptor modulators (ex. raloxifen), estrogen replacement therapy.

Alcohol Withdrawal Delirium Asssessment

1. Disorientation 2. Paranoia 3. Ideas of reference 4. Suicide attempts 5. Grand mal seizures

Acute Alcohol Intoxication Assessment

1. Drowsiness 2. Slurred speech 3. Tremors 4. Impaired thinking 5. Belligerence 6. Loss of inhibitions

Patient teaching for Herniated Intervertebral Disk

1. Exercise daily but avoid strenuous exercised 2. Correct posture at all times 3. Avoid prolonged sitting, standing, walking, driving 4. Rest at intervals 5. Use hardboard or firm mattress for bed 6. Avoid prone position 7. Avoid straining or lifting heavy objects.

Transfer: Assist to Stand

1. Face to face with patient 2. Grasp each side of pt's rib cage 3. Push knee against clients knee 4. Rock pt forward to standing position 5. Pivot pt to sit in chair 6. Place chair on pts stronger side

Cannabis Derivative Abuse Assessment

1. Fatique 2. Paranoia 3. Suphoria 4. Increased appetite 4. Disoriented behavior

Cannabis Derivative Abuse symptoms of withdrawal

1. Insomnia 2. hyperactivity 3. Decreased appetitite

Stimulant Abuse Implementation

1. Maintain airway 2. Start VI 3. Check LOC and VS 4. Activated Charcoal 5. Gastric lavage 6. Monitor for suicide

Narcotic abuse Implementation

1. Maintain airway 2. control seizures 3. Check LOC and VS 4. Narcan to reverse respiratory depression 5. IV glucose 6. Hemodialysis to eliminate drug from the bdoy

Nonalcoholic Sub. Abuse - Barbiturate Abuse Implementation

1. Maintain airway 2., check LOC and VS often, can go into shock or have cardiac arrest 3.Start IV with large-gauge needle 4. may give Sodium bicarbonate 5.May use Activated charcoal 6. may do a Gastric lavage 7. May do Hemodialysis

General care for Nonalcoholic Sutstance Abuse

1. Maintain airway 2. Administer Narcan -stimulates respirations 3. May require Gastric lavage, dialysis - couple of ways to rid system of the drug 4. Seizure precautions 5. Decrease stimuli, calm environment, protect from self destructive behaviors 6. Stay with patient 7. provide rest, nutrition and 8. therapy - group, individual

Hallucinogen Abuse Implementation

1. Maintain airway 2. Control seizures 3. Check LOC and V S 4. "Talk down" client 5. Reduce sensory stimuli 6.Small doses of Valium

Postop plan for Herniated Intervertebral Disk

1. Maintain body alignment 2. Log-roll every two hours with pillow between legs 3. Calf exercises 4. Assess for sensation and circulatory status, especially of lower extremities. 5. Monitor elimination 6. Assist with ambulation 7. Support neck after cervical laminectomy 8. Straight back during ambulation.

Osteomyelitis: Plan/Tx

1. Medications: analgesics, antibiotics, antipyretics. 2. Teach about risk factors for osteomyelitis (eg. joint prostheses) 4. Support affected extremity with pillows, splints to maintain proper body alignment. 5. Provide cool environment and lightweight clothing. 6. Avoid exercise and heat application to the affected area. 7. Encourage fluid intake, monitor intake and output. 8. Asepsis with wound care 9. Provide diversionary activities 10. High-protien diet with sufficient carbohydrates, vitamins, and minerals (build bone) 11. Instruct about home wound care and antibiotics administration

Korsakoff's Psychosis assessment

1. Memory disturbances with confabulation (Making it up) 2. Learning problems 3. Altered taste and smell 4. Loss of reality testing

So implementation with either/or Alcohol Withdrawal and Delirium

1. Monitor VS, especially pulse 2. Administer sedation, anticonvulsants(usually given if has a history of seizures), thiamine (IV or IM), Glucose (IV) 3. Place in a quiet, well lighted environment(light to prevent illusions) 4. Stay with patient to inc their orientation, minimize their confusion, dec stimuli- no visitors, no TV, o phones

Transfer: Assist Out of Bed

1. Move toward stronger side 2. Use leg muscles, not back to move client 3. Use draw sheets 4. Have assistant

hallucinogen abuse assessment

1. Nystagmus 2. Confusion 3. Hyperactivity 4. Distorted body image 5. Delirium 6. Self injury 7. Flashbacks

Chronic Alcohol Dependence Assessment

1. Persistent incapacitation 2. Cyclic drinking or 'binges' 3. Others in family take over client's role - codependence 4. family violence

Characteristics of Nonalcoholic Substance Abuse

1. Physiological and psychological dependence 2. Increasing doses needed to maintain 'high' 3. Low frustration tolerance 4. Need for immediate gratification

Transfer: Assist to sit on side of bed

1. Place hand under shoulders and knees 2. Have client push elbow into bed 3. Lift shoulders and swing legs over edge of bed

Acute Alcohol Intoxication Implementation

1. Protect airway 2. Assess for injuries 3. Assess for withdrawal 4. Assess need for IV glucose 5. Counsel about alcohol use

Plan for Developmental Dysplasia of the Hip (DDH): Newborn to 6 months

1. Reduced by manipulation 2. Splinted with proximal femur centered in the acetabulum in position of flexion. 3. Pavlik harness:worn full-time for 3-6 months until hip is stable for infants <3 mos. 4. Encourage normal growth and development by allowing child to perform appropriate activites 5. Teach parent to reapply harness and explain rationale for maintaining abduction 6. Tell parents to move child from one room to another for environmental change 7. Discuss modification in bathing, dressing, and diapering with parents. 8. Tell parent to touch and hold the child to express affectopm and reinforce security Modifications: 1.Since harness is not to be removed, sponge bath is recommended 2. Put undershirt under chest straps and knee socks under foot and leg pieces to prevent skin irritation. 3. Check skin areas 2-3 times/day. 4. Massage skin under straps daily to stimulate circulation. 5. Avoid lotions and powders. 6. Place diapers under straps. 7. Pad shoulder straps as needed.

NArcotic abuse Assessment

1. Respiratory Depression 2. Hyperpyrexia 3. Seizures 4. Pinpoint pupils 5. Stupor, coma

Non alcoholic Sub. Abuse - Barbiturate Abuse Assessment

1. Respiratory depression 2. Decreased pulse and BP 3. Ataxia 4. Seizures 5. Poor coordination at the very least will see decreased mental alertness of the client

Alzheimer's Disease Plan

1. Support cognitive function: Calm, predictable environment and present change gradually. a. Establish regular routine, clear instructions. b. Give clear and simple explanations and repeat information c. Display clock and calendar d. Color code objects and areas 2. Provide for safety: Night light, avoid restraints (increases combat). Reduce anxiety and agitation: Encourage walking, keep environment simple. Promote good nutrition:One dish at a time to prevent playing with food. Promote balance of activity and rest Administer medications: Cholinesterase inhibitors, NMDA-receptor antagonists, antidepressants.

Alcohol-related Disorders: Need to Know

1. Symptoms of intoxication and withdrawal 2. Implementations for intoxication and withdrawal 3. CNS disorders associated with chronic alcohol abuse- esp substance abuse delierium

Stimulant Abuse Assessment

1. Tachycardia, Inc. BP, Tachypnea( or fast respiration) 2. Agitation, Hyperactivity 3. Seizures 4. Hyperpyrexia (elevated temperature) 5. Hallucinations

Wernicke's Syndrome Implement

1. Thiamine (IM or IV) 2. Abstinence from alcohol

Nonalcoholic Substance Abuse: Need to Know

1. Types of nonalcoholic substance abuse 2. Symptoms of abuse and withdrawal 3. Implementation for withdrawal

Nonalcoholic Sub. Abuse - Barbiturate symptoms of withdrawal

1. anxiety 2. Insomnia 3. Tremors 4. Delirium 5. Convulsions

Concepts you see with Chemical Dependency

1. loss of control over injestion of the substance 2.may not want to do it 3. Many times creates issue in their lives, relationship issues, work issues or legal issues 3. Tendency to relapse 4. Person develops a tolerance of the drug or substance- need greater and greater amts to achieve their goal with the drug/substance 5. Withdrawl - physical and psychological symptoms

Etiology 3- development of cancer (multifunctional) (a. physical)

1. radiation 2. foreign bodies 3. chronic irritation

ET3-Genetic

1. strong disposition 2. Inherited chromsomal abonormalities

specific gravity normal range

1.010-1.030

If hypoglycemic, but conscious, what should you administer?

10-15 carbs, perferably skim milk 4oz

normal BUN levels for urine

10-20 mg/dl

oliguria

100-400 ml/24 hours of urine

What is the incidence of appendictitis?

11-30yrs old

trach cuff pressure

14-20

how old should toilet training occur

18 months old

Insulin: Intermediate Acting Duration

18-26h

how often do u assess need for suctioning?

2 hrs

AMI intake rec

2,000 ml/day

Insulin: Combination Peak

2-12h

how old toilet training where regular voiding habits and bladder reflex is controlled

2-3 years old

how often is the teflon cath of an insulin pump changed?

2-3days

if taking insulin, how many times a day at a minimum should a pt check their BG levels?

2-4 times qday no insulin- 2-3wk

how long is TB client isolated for

2-4 weeks isolated until 3 negative sputum cultures

Insulin: Fast Acting Peak

2-4h

Narcotic abuse symptoms of withdrawal

2. watery eyes, runny nose 3. irritability 4. tremors, panic 5. cramps 6. shills and sweating 7. Hallucinations

holter monitor

24 hour EKG with diary of ADL's

how soon can a mom feed her baby with formula after a pyloric stenosis surgery?

24 hours

Insulin: Slow Acting Duration

24-36h

Insulin: Combination Duration

24h

Insulin: Intermediate Acting Onset

2h

When do infants usually show s/s of pyloric stenosis?

2nd-4th week after birth regurg develops into projectile vomiting

meds for lyme disease

3-4 weeks antibiotics

sample meal items for high protein diet

30 grams powdered skim milk, roast beef sandwich & skim milk

When should the pancreatic enzyme, Cotazym, be given to a child?

30 mins before meals, or with meals.

head injury position

30 to decrease ICP

compression:vent ratio children/infants

30:2 single rescuer; 15:2 two HCP

safety and infection control

34.41

independent bathroom acitivity age

4 years old

normal HbA1c

4-6%

How often do you remove contents from a Koch pouch?

4-6hrs via catheter post op: q3hr instill 10-20mls NS into pouch, drain by gravitiy, kept in place 2 wks to drain: lube cath, insert 2inches, drain into toliet if resistance, inject 20ml air or water

phase 2 of first stage of labor (active)

4-7 cm dilated, 30-40 seconds/3-5 min apart moderate to strong intensity

normal pH of urine

4.5-8.0

what can decrease # and duration of migraines?

400 mg Riboflavin (Vit B2) daily

Insulin: Slow Acting Onset

4h

night-time bladder control at what age

5 years old

Antineoplastic: Antimetabolites Med Names

5-FU, Methotrexate

tPA within how many hours of AMI?

6 hrs onset

Insulin: Intermediate Acting Peak

6-12h

Plan for Developmental Dysplasia of the Hip (DDH): >6 months

6-18 months: Gradual reduction by traction (bilateral Bryant's traction). Cast for immobilization. Older Child: Preliminary traction. Open reduction. Hip Spica Cast.

Insulin: Fast Acting Duration

6-8h

after a hernia repair, how long should pt avoid heavy activities?

6-8wks

normal fasting bg level

60-110

phase 3 of first stage of labor(transition)

8-10 cm dialted, 45-90 seconds/2-3 minutes apart, strong intensity

Insulin: Slow Acting Peak

8-20h

anuria< 100 ml/24 hours

< 100 ml/24 hours

polyuria (diabetes insipidus)

> 2000 ml/day of urine

what lab value is PKU confirmed at? What is a normal number for a newborn?

>20mg/dl confirmed PKU normal newborn = 1.2-3.4 after = 0.-1.8

when you should test for PKU?

>24hrs after birth but NOT after 7days closest to d/c as possible

Myasthenia Gravis: S/Sx

A chronic progressive disease characterized by chronic fatigue and muscular weakness (especially in the face and neck). Deficiency of acetylcholine at myoneural junction. Analysis: Deficiency of Ach at myoneural jxn Etiology: Unclear Chronic and Progressive Intellect Intact Diagnosis: based on administration of anticholinesterase; positive result evidenced by a striking increase in muscular strength 5-10 minutes after administration No muscular atrophy No loss of sensation Muscular weakness produced by repeated movements soon disappears following rest. Diplopia, ptosis, impaired speech, dysphagia. Respiratory distress. Periods of remission and exacerbation.

Multiple Sclerosis:S/Sx

A chronic progressive nervous disorder involving loss of myelin sheath around certain nerve fibers. Analysis: Demyelination of white matter throughout brain and spinal cord. Etiology: unclear Chronic and Progressive Intellect Intact Leads to paraplegia or complete paralysis Early: Vision, motor sensation changes Late: Cognitive and bowel changes, muscular incoordination, ataxia, spasticity, intention tremors, nystagmus, chewing and swallowing difficulties, impaires speech. Incontinence, emotional instability, sexual dysfunction.

post-traumatic stress disorder (PTSD)

A chronic, sometimes lifelong disorder that may follow a traumatic experience. Symptoms include dissociation, recurrent nightmares, flashbacks, and sleep disturbances.

multicausal model

A conception of how mental disorders arise that emphasizes the roles played by many different factors.

diathesis-stress model

A conception of psychopathology that distinguishes factors that create a risk of illness (the diathesis) from the factors that turn the risk into a problem (the stress).

generalized anxiety disorder (GAD)

A disorder characterized by pervasive, free-floating anxiety.

dissociative identity disorder (DID)

A disorder that results in a person developing two or more distinct personalities.

neurodevelopmental disorder

A disorder that stems from early brain abnormalities.

autism

A disorder usually diagnosed in young children, and characterized by a wide range of developmental problems, including language and motor problems.

attention-deficit/hyperactivity disorder (ADHD)

A disorder usually diagnosed in young children, and characterized by impulsivity, difficulty staying focused on a task, and a range of behavioral problems.

obsessive-compulsive disorder (OCD)

A disorder whose symptoms are obsessions and compulsions, which seem to serve as defenses against anxiety.

agoraphobia

A fear of being in situations in which help might not be available or escape might be difficult or embarrassing. See also phobia.

anxiety disorders

A group of disorders distinguished by feelings of intense distress and worry, and in many cases, disruptive and unsuccessful attempts to deal with these feelings.

mood disorders

A group of disorders distinguished primarily by changes in positive and negative affective state.

schizophrenia

A group of severe mental disorders characterized by at least some of the following: marked disturbance of thought, withdrawal, inappropriate or flat emotions, delusions, and hallucinations.

hypomania

A mild manic state in which the individual seems infectiously merry, extremely talkative, charming, and tireless.

depression

A mood disorder characterized by disabling sadness, hopelessness, and apathy; a loss of energy, pleasure, and motivation; and disturbances of sleep, diet, and other bodily functions. Also called major depression or unipolar depression.

bipolar disorder

A mood disorder in which the patient swings between emotional extremes, experiencing both manic and depressive episodes.

mixed states

A pattern sometimes observed with bipolar disorder in which the person displays a combination of manic and depressive symptoms.

explanatory style

A person's characteristic way of explaining his experiences. Consistently attributing bad experiences to internal, global, and stable causes may increase vulnerability to depression.

biopsychosocial perspective

A perspective on psychopathology that emphasizes the biological, psychological, and social factors that contribute to mental illness.

Disturbed Transmission of Nerve Impulses: Parkinson's Disease: S/Sx

A progressive disease that destroys brain cells and is identified by muscular tremors, slowing of movement, and partial facial paralysis. Deficiency of dopamine; increased acetylcholine levels. Analysis: Deficiency of dopamine Increased Ach levels Etiology: unclear Chronic and Progressive Intellect Intact Does not lead to paralysis Tremors (pill rolling motion), akinesia (loss of voluntary movement), rigidity, weakness. Motorized propulsive gait, slurred monotonous speech, dysphagia. Salvation, masklike expression, drooling. Constipation Depression Dementia

acute stress disorder

A reaction sometimes observed in individuals who have experienced a trauma, characterized by flashbacks and recurrent nightmares.

Trousseau's sign

A sign of hypocalcemia . Carpal spasm caused by inflating a blood pressure cuff above the client's systolic pressure and leaving it in place for 3 minutes.

mania

A state characterized by racing thoughts, pressured speech, irritability or euphoria, and impaired judgment. See also bipolar disorder.

dissociative fugue

A state in which someone leaves home, then, days or months later, suddenly realizes he is in a strange place and doesn't know how he got there; often understood as a means of coping with (and escaping from) extremely painful events.

panic attack

A sudden episode of terrifying bodily symptoms such as labored breathing, choking, dizziness, tingling hands and feet, sweating, trembling, heart palpitations, and chest pain.

Antidysrhythmics Uses

A-Fib and flutter, tachycardia, PVCs

Antimetabolites -indications

A-acute lymphatic leukemia R-Rhematuid arthiritis P-Psorriasis C-Cancer of colon, breast, stomach S-sickle cell anemia

-pril

ACE-Inhibitors

Attention Disorder Agents Uses

ADD, narcolepsy

false positives

AFP has a high incidence of this result

activity, pulse, grimace, appearance, respiration

APGAR from 0-2 from each of these categories with a total number = 10

-sartan

ARBs

what meds increase risk of hypoglycemia effect on PO hypoglycemic agents?

ASA ETOH Sulfonamides oral contraceptives MAOIs

what meds increase risk of hypogyclema on inusulin?

ASA ETOH Tetracycline oral contraceptives tricyclic antidepressants MAOIS

what types of vascular access can client on hemodialysis receive

AV fistula, AV graft, or subclavian catheter

Plan for Scoliosis

Abdominal muscle isometric exercise for functional type (sit-ups, pelvic tilt, push ups with pelvic tilt). Electrostimulation Surgery: Spinal fusion with Harrington rod insertion; Dwyer instrumentation with anterior spinal fusion; screw and wire (Luque) Thoracolumbosacral orthotic brace (TLSO) Boston Brace

Care after THR

Abduction pillows Don't sleep on operated side Don't flex hip more than 45-60 Don't elevate head of bed more than 45

negative cognitive schema

According to Aaron Beck, the core cognitive component of depression, consisting of an individual's automatic negative interpretations concerning himself, his future, and the world. See also explanatory style.

compensatory behavior

Actions taken to ensure that binge eating does not translate into weight gain (e.g., self-induced vomiting).

Atypical Antipsychotic Agents Uses

Acute and chronic psychoses

Glucocorticoids Uses

Addison's disease, Crohn's disease, COPD, leukemias

Myasthenia Gravis: Tx

Administer medication:Anticholinesterases, Corticosteroids, Immunosuppressants. Promote understanding of the disease a. it is neither a CNS nor a peripheral nervous system disease b. There is no muscular atrophy or loss of sensation c. It is not hereditary Good eye care Maintain optimal mobility Provide environment that is restful and free of stress Importance of taking meds on time Wear Medic-Alert band Avoid factors that may precipitate myasthenia crisis (infections, emotional upsets, use of streptomycin or neomycin (they produce muscular weakness), surgery. Be alert for myasthenia crisis:sudden inability to swallow, speak, or maintain a patent airway.

Antineoplastic: Antitumor Med Names

Adriamycin, Bleomycin, Actinomycin D

Chronic Slcohol Dependence nurse Implementation

Aim of treatment is that the person accepts responsibility for their recovery - nurse shd develop a warm caring relationship with client so he feels safe 1.Identify problems related to drinking 2. client see the problem the alcohol is causing on himself and/or family 3. Establish control of problem 4. Alcoholics Anonymous 5. Anabuse-medication that cause a strong reaction when they injest alcohol 6. Counsel spouse and children

Bone-Reabsorption Inhibitors: Biophosphonates Med Names

Alendronate (fosamax), Risedronate (actonel), Ibandronate (boniva)

Antibiotics General

Allergies, Super Infections, Organ Toxicity

-zosin

Alpha 1-Blocker

PKU (cause, risk, tx/diet)

Alteration in protein metabolism... cause: error of phenylalanine utilization risk: high levels = mental retardation tx: spec prepared milk ( Lofenalac) and LOW PROTEIN diet AVOID ASPARTAME (neutrasweet) avoid high protein foods (meats/dairy)

Bronchodilators Med Names

Aminophylline, Brethine, Atrovent, Proventil, Primatene mist

Antifungals: Med Names

Amphotericin B, Nystatin

phobia

An anxiety disorder characterized by an intense and, at least on the surface, irrational fear.

panic disorder

An anxiety disorder characterized by repeated or disabling panic attacks. See also anxiety disorders, panic attack.

anorexia nervosa

An eating disorder characterized by an extreme concern with being overweight and by compulsive dieting, sometimes to the point of self-starvation. See also bulimia nervosa.

bulimia nervosa

An eating disorder characterized by repeated bingeand- purge bouts. See also anorexia nervosa.

semistructured interview

An interview in which questions are posed in a standardized yet flexible way.

what type of med may you give to a patient with gastritis?

Antacids - often relieve pain

Furadantin (nitrofurantoin) Nursing Considerations

Anti-infective Give w food or milk Monitor pulmonary status Take w/ cranberry juice

Diet/medications for uncomplicated diverticular dx?

Antispasmodics, anticholinergic (Bentyl) Bulk Laxatives (Metamucil) HIGH FIBER AVOID foods w/seeds! Increase Fluds

Antidepressants: SSRIs Side Effects

Anxiety, gi upset, change in appetite and bowel function, urinary retention

specific phobias

Any of the disorders characterized by extreme and irrational fear of a particular object or situation.

Pt arrives with right lower quad pain, N/V, low grade fever ....what might you suspect?

Appendicitis

Amyotrophic Lateral Sclerosis (ALS):Plan/Tx

Apply principles of care f client with progressive, terminal disease. Treat self-care deficits symptomatically Maintain adequate nutrition PT Adaptive home equipment Provide psychosocial support

Antiplatelet Agents Med Names

Aspirin, Persantine, Plavix

dopamine hypothesis

Asserts that the brains of people with schizophrenia are oversensitive to the neurotransmitter dopamine. See classical antipsychotics.

Teaching ADLs

Assess client abilities Exercise muscles needed for activity Start with gross movements, follow with finer movements Extend activity according to client tolerance Give positive feedback

Rheumatoid/Juvenile Rheumatoid Arthritis(JRA): Assessment/Diagnostic tests

Assessment: Joint pain, swelling, and limitation of movement. Contracture deformities Nodules over bony prominences Ulnar deviation High fever and rheumatoid rash (seen in JRA) Salmon-pink macular rash (small, flat red dots) on chest, thighs, and upper arms. Diagnose: Systemic disease, remissions and exacerbations, bony ankylosis, progressive Diagnostic testing: Rheumatoid factor (autoantibody), C-reactive protein, ESR (sed-rate), ANA (in JRA), Aspirationof synovial fluid, X-Rays.

Gout: Assessment/Diagnostic tests

Assessment: Joint pain, swelling, limitation of movement. Contracture deformitites Tophi (buildup of urate crystals) Diagnose: Nonsystemic; disturbed purine metabolism; eleated uric acid in blood; tophi formation (deposits of urates in joints); exacerbations Diagnostic Tests" Xrays Blod Test- WBC, ESR, uric acid level Synovial aspiration

Immobility: Negative Nitrogen Balance

Assessment: Anorexia, debilitation, weight loss Implementation:High protein diet, small-frequent feedings

Immobility: Contractures

Assessment: Deformity d/t muscle stiffening Implementation: Equipment-pillows, trochanter rolls, foot board, frequently change position, exercise

Multiple Sclerosis (CNS)

Assessment: Demyelination of white matter in brain and spinal canal, changes in vision, sensation, motor function Early: vision, motor sensation changes Late: cognitive and bowel changes Implementation: Bladder and bowel training, ROM and coordination exercise Medications: muscle relaxants, immunosupressants, corticosteroids, antispasmodics

Gout

Assessment: Due to the build up of uric acids, avoid foods that are high in purines, joint pain, swelling, limitation of movement Implementation: Avoid foods rich in purines, medications-analgesics, anti-inflammatory

Hydrocephalus

Assessment: Increase in CSF withing ventricular system, Increase in fronto-occipital circumference, widened, distended fontanelles. Implementation: treated by insertion of shunt (ventriculoperitoneal shunt

Osteoarthritis

Assessment: Often associated with older age,and repetitive use of the joint, joint pain, swelling, limited movement, joint stiffness after rest

Immobility: Osteoporosis

Assessment: Pathological fractures, renal calculi (high serum Ca level: Normal Ca:8.5-10) Implementation: Weight-bearing on long bones, balanced diet, estrogen replacement therapy

Amyotrophic Lateral Sclerosis (PNS)

Assessment: Progressive, degenerative disease of motor neurons, atrophy with fascicualtions (brief muscle twitching), nasal quality to speech, dysarthria (difficulty speaking), dysphagia, aspiration Implementation: Maintain nutrition, PT, psychological support

Immobility: Thrombus Formation

Assessment: Pulmonary emboli Implementation: TED hose, leg exercises, change position, do not use bed knee gatch, no pillows behind knees, check homan's sign

Scoliosis

Assessment: Screening procedure, postural changes Implementation: Exercise for functional type, electrostimulation, braces, surgery: spinal fusion

Immobility: Increased Cardiac Workload

Assessment: Tachycardia Implementation: Use trapeze when moving in bed, teach to move without holding breath (valsalva maneuver)

Immobility: Urinary Stasis

Assessment: Urinary retention, renal calculi Implementation: Normal position to void, increase fluid intake, low-calcium diet, acidify urine.

Muscular Dystrophy

Assessment: atrophy of voluntary muscles, muscle weakness, lordosis/scoliosis, waddling gait, joint contractures, falls Implementation: Braces to help ambulation, balance activity and rest

Rheumatoid Arthritis

Assessment: contracture deformities, nodules, fever, rash, systemic disease that can worsen over time

Myasthenia Gravis (PNS)

Assessment: deficiency of acetylcholine, muscular weakness produced by repeated movement, dyphagia, respiratory distress, diplopia, ptosis (eyelid drooping), impaired speech, dysphagia. (MG crisis affects pt's airway, emergency!) Implementation: Good eye care, restful environment Medications: anticholinesterases, corticosteroids, immunosuppressants

Parkinson's Disease (CNS)

Assessment: deficiency of dopamine, tremors (pill-rolling) , akinesia (loss of automation) rigidity, "motorized" propulsive gait, slurred monotonus speech, dysohagia, salivation, mask-like expression, drooling, constipation, depression, dementia Implementation: Teach ambulation modification, ROM exercises Medications: Artane, Cogentin, L-Dopa, Parlodel, Sinement, Symmetrel

Fractures

Assessment: deformity, crepitus, absent pulses, swelling, pallor

Dislocation

Assessment: displacement of joint bones so their articulating surfaces lose all contact Implementation: considered and orthopedic emergency; treated with immobilization and reduction, eg the dislocated bone is brought back to its normal position, usually under anesthesia; bandages and splints are used to keep affected part immobile until healing occurs.

Immobility: Stasis of respiratory secretions

Assessment: hypostatic pneumonia Implementation: Turn, cough, deep breathe, postural drainage

Contusion (bruise)

Assessment: injury to soft tissue, ecchymosis. hematoma Implementation: treat with cold application for 24 hours followed by moist heat; apply elastic bandage

Fractured Hip

Assessment: leg shortened, adducted,externally rotated, pain, hematoma, ecchymosis, confirmed by x-rays Dx: commonly seen with elderly women with osteoporosis

Strains

Assessment: muscle and/or tendon pull or tear, pain, swelling Implementation: treated with rest and elevation of affected part; intermittent ice compress for 24 hours, followed by heat application; apply elastic pressure bandage; minimize use

Developmental Dysplasia of the Hip

Assessment: often found in children when the head of the femur is disloacted from the acetabulum, uneven gluteal folds and thigh creases, limited abduction of hip, Ortolani's sign, shortened limb on affected side. Implementation: (newborn to 6 mo) reduced by manipulation, Pavlik harness for 3-6 mo, teach about harness and body care (6-18 mo) traction, immobilization by cast (older child) traction and ORIF

Herniated Intervertebral disk

Assessment: pain muscle tone, poor body mechanics/posture Treatment: Meds (NSAIDs , muscle relaxers), traction, TENS DX test: CT, MRI Surgical: Laminectomy Post op care: positioning log rolling, firm mattress, make sure they have proper body alignment, assess stimulation in lower extremities, proper body alignment, erect posture, avoid prolonged sitting and standing

Osteomyelitis

Assessment: pain swelling, redness, infection caused by staphylococcus aureus, confirmed by x-ray Implementation: Medication-analgesics, antibiotics, high-protein diet

Sprains

Assessment: torn ligament or stretched ligament, pain, swelling Implementation: treated with rest and elevation of affected part; intermittent ice compress for 24 hours, followed by heat application; apply elastic pressure bandage; minimize use

Cerebral Palsy

Assessment: voluntary muscles poorly controlled due to brain damage. Spasticity, rigidity, ataxia, repetitive involuntary gross motor movements. Neonate: Cannot hold head up, feeble cry, inability to feed body noticeably arched or limp Infant: FTT Toddler: mental retardation, delayed physical development Implementation: Ambulation devices, PT and OT, muscle relaxants and anticonvulsants.

Immobility: Orthostatic Hypotension

Assessment: weakness, dizziness Implementation: Change position slowly, increase activity gradually

Osteoarthritis: Assessment/Diagnostic tests

Assessment:Joint pain, swelling, and limitation of movement. Joint stiffness after rest. Heberden's nodes of fingers and bouchard's nodes of hands. Diagnose: Nonsystemic; spur formation, closure of joint spaces; degenerative, no remission *Increase in age, obesity, no family hx, no exacerbations, Diagnostic Testing: Xays of joints show narrowing of joint spaces.

Antidysrhythmics Med Names

Atropine, Lidocaine, Pronestyl, Quinidine, Isuprel

Antidepressants: MAOIs Nursing Considerations

Avoid foods containing tyramine Monitor Output Takes 4 wks to work Do not take with cold medications or CNS stimulates

Chemo 1 Alkylating agent side effects

B-Bone marrow suppression N-Nausea, vomiting S-tomatitis A- Alopecia G-gonadal suppression R- renal toxicity (cistplain) O-(ototoxicity)

AMI meds

BBlockers, morphin (reduces preload, afterload pressures, dec anxiety), dysrhythmics (lidocaine, verapamil, solalol, propafenone), anticoags (hep, coum)

Alkylating Agents

BCCC Bulsifan chlormabucil cistiplain cyclosphosphimade

If a pt arrives, - confused, cool, clammy - what would be your initial assessment?

BG <50-60?

s/s of HHNK

BG >800 dry, seizures,

trousseaus sign of hypocalcemia

BP cuff 20 mmHg above systolic on notice the muscle contraction of the hand and wrist

prostate gland hypertrophy

BPH benign prostatic hyperplasia

what s/s would you look for with DM Ketoacidosi

BS 300-500 ph: <7.5 ACIDIC /bicarb <15 dry, warm, kussmaul (rapid) breathing, fruity oder breath,

detached retina trmt

Bedrest, don't move forward, affected eye or both eye may be patched to decrease movt,, area of detachment should be in DEPENDENT position, no hair washing for a week, admin sedatives/tranquilizers

Antitussive Agents Med Names

Benylin DM, Robitussin

Romazicon

Benzodiazepines

-pam or -am

Benzodiazepines ending

-lol

Beta Blockers

Antithyroid Agents Nursing Considerations

Bitter Taste May cause burning in mouth Give with meals Check CBC

Thrombolytics Side Effects

Bleeding, bradycardia, dysrhythmias

Antitumor Examples atbs

Blexoane, Anctinomycin D, adriamycin

Cast - Watch for these Danger Signs

Blueness or paleness, Pain, Numbness, or tingling sensations on affected area What to do? --Elevate casted area --If persists, contact Physician

Antibiotics: Cephalosporins Side Effects

Bone Marrow Depression, Superinfections, Rash

Alkylating Agent- Myleran SE

Bone marrow suppression

VInca allkaloids SE's

Bone marrow suppression Neuropathies Stomatiis

Antimetabolites examples

CFPMM Cytaarbine-(ARA_C) Flurouracil(5-FU) Pemextred(altima) Mercaptopurine(6-mp) methotrexate)(mtx)

Diuretics Uses

CHF, renal disease

Andrenergics Uses

COPD, Cardiac Arrest

Bronchodilators Uses

COPD, preterm labor

Antineoplastic: Hormonal Agents Uses

Cancer

Most widely illiceit drug used in US...

Cannabis (marijana) client is looking for euphoria, relaxation, detachment

Cytoprotective Agents Med Names

Carafate

Laxatives/Stool Softeners Med Names

Cascara, Dulcolax, Colace, MOM

Antibiotics: Cephalosporins Med Names

Ceclor, Ancef, Keflex, Rocephin, Mefoxin

Antibiotics: Cephalosporins

Ceph-, Cef, Kef

Antipsychotic Agents Nruisng Considerations

Check CBC Monitor VS Avoid alcohol and caffeine

Antineoplastic: Hormonal Agents Nursing Considerations

Check CBC Monitor serum calcium

Antitubercular Agents Nursing Considerations

Check LFT Vit B6 given for peripheral neuritis Used in combination

Antianginals Nursing Considerations

Check expiration date Teach when to take medication May take q 5 min x 3 doses Wet with saliva and place under tongue

Antibiotics: Penicillins Nursing Considerations

Check for hypersensitivity Give 1-2 h before or 2-3 h after meals Cross allergy to cephalosporins

Antiplatelet Agents Nursing Considerations

Check for signs of bleeding Give with food or milk

Antibiotics: Aminoglycosides Nursing Considerations

Checking 8th cranial nerve (hearing) Check Renal Function (BUN) Take for 7-10 days Encourage Fluids (3,000ml/day when pushing)

Antineoplastic: Alkylating Agents Nurisng Considerations

Checking hematopoietic function Force fluids Good mouth care

Antihistamines: Med Names

Chlor-Trimeton, Benadryl, Phenergan

Chrons dx vs ulcerative colitis: area of involvement ileum, R-colon

Chrons UC: rectum - L colon

Chrons dx vs ulcerative colitis: frequent steatorrhea

Chrons Dx absent in UC

Chrons dx vs ulcerative colitis: fistula

Chrons dx rare in UC

Antibiotics: Fluoroquinolones Med Names

Cipro

Antineoplastic: Alkylating Agents Med Names

Cisplatin, Myleran, Cytoxan

Sleep Apnea Syndrome Data

Client snores loudly, stops breathing for 10 secs or more, then awakens abruptly with loud snort; multiple nightime awakenings. Excessive daytime sleepiness Morning h/a Sore throat Personality an behavioral changes Dysrhythmias, hypertension, increased risk of stroke, myocardial infarction and heart failure.

Atypical Antipsychotic Agents Med Names

Clozaril, Risperdal

Antigout Agents: Med Names

Colchicine, Probenecid, Allopurinol

Mag Sulfate - Anticonvulsant

Common given in OB Deep Tendon Reflexes be evaluated SE: Resp Arrest

Types of fractures

Complete: break across entire cross-section of bone Incomplete: break through portion of bone Closed: no external communication Open: extends through skin

Lumbar Lordosis

Concavity in lumbar region

Laxatives/Stool Softeners Nursing Considerations

Contraindicated w symptoms of acute abd Monitor fluid and electrolytes Chronic uses may cause hypokalemia Encourage fluid

Kyphosis

Convexity in thoracic region

Antibiotics: Fluoroquinolones Nursing Consideration

Culture and Sensity before starting therapy Encourage Fluids (3000ml.day) Take 1 h before or 2 h after meals

if mom reports that her child tastes "salty" when kissed, what may you suspect?

Cystic fibrosis

personal-social, fine motor, language, gross motor

DDST tests these four categories of development

during treatment of a glucose disorder, which would you watch for increase icp?

DKA if blood glucose levels fall to far or too fast before the brain has time to equilibrate, water is pulled from the blood to the CSF and the brain causing cerebral edema and increase ICP

ET3- viral-incorporated in cells neogeneisis

DNA RNA virus, epstein barr virus, burkitt's lymphoma.

deptheria, tetanus, pertussis

DTaP stands for

Osteoporosis: Data/Diagnose

Data: Decreased height Low Back Pain especially in hips and spine Kyphosis Diagnose: 1. Reduction in bone mass with no changes in mineral composition. 2. Degenerative disease characterized by generalized loss of bone density and tensil strength. 3. Diagnosed by bone mineral density (BMD)[Bone Density Scan] T-score: BMD T-score <2.5 indicates osteoporosis. 4. Risk factors: a. >60 years b. Small-framed and lean body build c. Caucasian or Asian Race d. Inadequate intake of Ca+ or Vi D e. Postmenopausal f. Immobility and sedentary lifestyle g. Hx of smoking h. High alcohol intake i. Prolonged use of steriods

Spina Bifida/Neural Tube Defects: Data/Diagnose/Risk Factor/Etiology

Data: Spina bifida occulta, meningocele, myelomenignocele. Hydrocephalus increases risk Paralysis of lower extremities Musculoskeletal deformities (club feet, dislocated his, kyphosis, scoliosis) Neurogenic bladder and bowel, prolapsed rectum. Diagnose: Congenital anomly of the spinal cord characterized by incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. Risk Factor: Maternal folic acid deficiency Previous pregnancy affected by neural tube defect. Etiology: Advanced maternal age High levels of alpha-fetoprotien at amniocentesis.

Bursitis

Data:Pain due to inflammation Decreased mobility, especially on abduction. Diagnose:Inflammation of connective tissue sac between muscles, tendons, and bone, particularly affecting shoulder, elbow, and knee. Plan: 1. Rest 2. Immobilize affected joint with pillows, splints, slings. 3. Administer pain medication, muscle relaxants (Valum), steroids. 4. Apply heat/cold packs to decrease swelling. 5. Promote exercise (ROM) 6. Assist in performance of ADL (Activities of Daily Living) by modifying activities relative to limitations. 7. Assist with cortisone injection, draining of bursae.

_____Results from reduced tissue sensitivity to insulin that usually devlops betwen 5am-8am causing prebreakfast hyperglycemia) what is its tx?

Dawn Phenomenon tx: admin evening dose (or increasing amt of current dose) of NPH at about 10pm

Myexedema/Hypothyroidism Plan

Decreased BMR, T3,T4, increased TSH Restrict use of soaps and apply lanolin or creams to skin High-protein, low-calorie diet Prevent constipation: high-fiber, high-cellulose foods, stool softeners Explain Sx are reversible with Tx Administer drug replacement therapy (synthroid, Cytomel [Liothyronine Sodium]). Administer sedatives carefully - risk of respiratory depression Instruct about causes of myxedema coma (acute illness, surgery, chemotherapy, discontinuation of medication).

Hypoparathyroidism diagnose

Decreased secretion of parathroid hormone Hypomagnesemia Diagnostic tests: Low serum calcium and parathyroid hormone (PTH), increased serum phosphorus. X-ray-bones appear dense.

Complications with immobility

Decubitus (Pressure) Ulcer: Osteomyelitis, Tissue Maceration, Infection Sensory Input Changes: confusion, disorientation (orient frequently)

Data collection for Scoliosis

Definition: Lateral deviation of one or more vertebrae commonly accompanied by rotary motion Poor posture Uneven hips or scapulae Kyphosis: lump on back Uneven waistline Visualization of deformity:bend at waist (90degrees)

which glucose disorder does acidosis occur and formation of ketones?

Diabetic ketoacidosis

Antidiabetic Agents: Med Names

Diabinese, Orinase, Dymelor, Micronase

Hydrocephalus: Diagnose/Cause/Types

Diagnose: Congenital or acquired condition characterized by increase in the accumulation of CSF within the ventricluar sysem and subsequest increase in ventricular pressure. Cause: Neoplasm Aqueductal stenosis (stenosis/obstructions in ventricular system Spina bifida Congenital cysts/vascular malformations. Types: Communicating-due to increased production of CSF or impaired absorption of CSF. Noncommunicating- due to obstruction/blockage of CSF circulation between ventricles and subarachnoid space.

Diagnoses of Herniated Intervertebral Disk

Diagnostic Procedures: 1. Computerized tomography 2. MRI 3. Myelography (encourage fluids, keep head of bed elevated 30 degrees to reduce risk of seizures) 4. Diskogram. Surgical Procedures: 1. Laminectomy (excision of a portion of the laminca to expose the affected disk for removal) 2. Laminectomy with fusion (Several disks fused using bone graft) 3. Microdiskectomy (minimally invasive surgery: removing part of the disk) 4, Interbody cage fusion

Carbonic Anhydrase Inhibitors Med Names

Diamox

Digoxin Antidote

Digibind

Digibind

Digoxin

Anticonvulsants Med Names

Dilantin, Luminal, Depakote, Tegretol, Klonopin

Pt presents with L-lower quad pain ....what may you suspect?

Diverticular Disease L-Lower quad pain usually relieved by passage of stool/flatus

Anticonvulsants Nursing Considerations

Don't d/c abruptly Monitor I&O Caution with use of meds that lower seizure thresholds (ex. MOAIs, antipyscotic) No alcohol Urine is pink/reddish

Dilantin - Anticonvulsant

Don't give too fast - cardiac arrest NEVER mix with another med Urine Pink

Hib and Neisseria meningitidis get what kinda precautions

Droplet

classical antipsychotics

Drugs (such as Thorazine and Haldol) that block dopamine receptors. These drugs seem to treat many positive symptoms of schizophrenia. See dopamine hypothesis.

After ulcer surgery, pt presents with hypotension, diaphoresis, diarrhea...what may you suspect?

Dumping Syndrome

Having type O blood and being male puts you at risk for what type of ulcer?

Duodenal Ulcer

Male pt, early 40s, arrives in the office with complaints of symtpoms occuring 2-3 hrs after a meal or often at nightime. He states that food intake tends to relieve his pain, which type of ulcer may you suspect?

Duodenal Ulcer

Andrenergics Side Effects

Dysrhythmias, Tremors, Anticholinergic Effects (dry mouth, urinary retention)

Antibiotics: Fluoroquinolones Uses

E. coli, Pseudomonas, S. aureus

records electrical activity in the brain

EEG electroecephalogram does this

what is the showck wave treatment for urolithiasis

ESWL extracorporeal shock wave lithotripsy

binge eating

Eating a large amount of food within a brief period.

Thoracolumbosacral Orthotic Brace (TLSO)

Effective for 30-40 degree curves not associated with extreme deformity. Underarm orthosis made of plastic custom molded to the body and shaped to correct or hold the deformity. Wear for 23 hours-removed 1 hour for personal hygiene. Wear protective shirt under brace. Skin care to pressure areas Reinforce teaching isometric exercises to strengthen ABD muscles.

Antidepressants: Tricyclics Med Names

Elavil, Tofranil, Norpamin

Hypoparathyroidism Tx

Emergency Tx; Calcium chloride or gluconate over 10-15 minutes. Calcitriol (Rocatrol) 0.5-2 mg daily for acute hypocalcemia. Ergocalciferol (vit d) 50,000-400,000 unites daily. Observe for tetany Low-phosphorus, high-calcium diet

Parkinson's Disease: Tx

Encourage finger exercises (typing, piano playing, etc) ROM as appropriate Teaching of ambulation a. Goose-stepping walk b. Walk with wider base c. Concentrate on swinging arms while walking d. Turn around slowly using small steps Teaching of understanding of disease: - Patient's intellect is not impaired, sight/hearing intact, disease is progressive but slow, does not lead to paralysis. Refer for speech therapy, potential stereotatic surgery. Administer dopaminegics (Sinemet); dopamine agonists (pramipexole); anticholinergic (benxtropine); antivirals (amntadine).

Antivirals Nursing Considerations

Encourage fluids Not a cure, but relieves symptoms

infant presents with excessive saliva, drooling, cyanosis, and choking/coughing. What may you suspect?

Esophagel Atresia or TEF 3 C's

Treating Pain

Establish therapeutic relationship Establish 24-hr pain profile Teach client about pain Provide comfort measures Administer analgesics Alternative methods

Main RN concern with Chron's/UC pts?

F& E balance

Preoperative concern for pyloric stenosis

F&E! - check fontanells (sunken-dehydration), U/O Correct common imbalance (alkalosis, hypokalemia)

late hypoxia, maternal drugs, prolonged cord compression, hypotension

FHR <110 bpm indicates fetal bradycardia these causes

infection, early hypoxia, anemia,

FHR >160 bpm indicates these possible causes from fetus/mother

late deceleration

FHR decelerate after contraction begin to subside caused by diabetes, placenta previa, HTN, abruptio placentae, non reassuring sign

early deceleration

FHR decelerate before peak of contraction caused by fetal head compression, 2nd stage of labor pushing

what is your main focus with HHNK besides fluid replacement?

FIND AND TX the cause!! (thiazides? acute illness? dialysis? TPN?)

What is your main RN concern with infections of the GI tract caused by E.coli, salmonella, shingella?

FVD! monitor I & O closely for pt extreme diarrhea likely

190= 1st hour, 140 = 2nd hour, 125 = 3rd hour

Fasting BS for GTT is 60-110 then what should be first three hours each after getting 75 gms of oral glucose

Hyperparathyroidism S/Sx

Fatigue, muscle weakness Caridac dysrhythmias Emotional irritability Renal calculi Back and joint pain, pathological fractures Pancreatitis, peptic ulcer

Iron Preparations Med Names

Feosol (ferrous sulfate) Imferon

Besides pain in the L-Lower quad, what may someone with diverticular dx present with?

Fever - increase WBCs Constipation alternating with diarrhea blood in stool

Antitubercular Agents Med Names

First Line -INH, Rifampin, Ethambutol, Streptomycin Second Line - PAS, PZA

Assistive Device: Walker

Flex elbow 20-30 degrees when hands are on grip, lift and move walker 8-10 in, step forward with bad leg support self on arms, follow with good leg

Functional Scoliosis

Flexible deviation that corrects by side-bending to the opposite side.

What is your major concern with diabetic ketoacidosis?

Fluid volume deficit - 1L 0.9 NaCL per hr during first 2-3hrs flw with 0.45% NaCL 200-500 ml/h then D5w

Plan for Club foot (Talipes Equinovarus)

Foot exercises: 1. Manipulation of foot to correct position every 4 hours regularly. 2. Casts and splints correct the deformity in most cases if applied early; changed every few days for 1-2 weeks, then at 1-2 weeks intervals to accommodate infant's rapid growth. 3. Surgery is usually required for older child. 4. Denis-Browne: Horizontal abduction bar with footplates.

Alzheimer's Disease Data

Forgetfulness progressing to inability to recognize familiar faces, places, objects. Depression, paranoia, combativness Unable to formulate concepts and think abstractly Impulsive behavior Short attention span Agitation and increase in physical activity Night wandering Inability to perform ADLs (unkempt appearance) Dysphagia Incontinence

what position do you want to place someone after appendictis?

Fowlers position - reileve ab pain, ease breathing

Hydrocephalus: Data

Fronto-occipital circumference increases at abnormally fast rate (from increaed CSF w/in ventricular system) Split sutures and widened distened, tense fontanelles. Prominent forehead, dilated scalp veins. Sunset eyes, nystagmus(uncontrolled movement of eyes) Irritability, vomiting, Unusual somnolence (sleepy, drowsy) Convulsions High-pitched cry

What type of surgery may be indicated for hiatal hernia?

Fundoplication

Antipyretic Side Effects

GI irritation, Liver dysfuction

common medical diagnoses for full liquid diets

GI upset

NSAIDS Side Effects

GI upset, dizziness, headaches, bleeding, fluid retention

Antihypertensives: Ace Inhibitors Side Effects

GI upset, orthostatic hypotension, dizziness

Bipolar Disorder: Side Effects

GI upset, tremors, polydipsia, polyuria

Causes of immobility

Gait Joint movement Muscle tone Skin integrity

Antibiotics: Sulfonamides Med Names

Gantrisin, Bactrim, Azulfidine

Which type of ulcer causes freq vomitting?

Gastic Ulcer

Chronic Gastritis can lead to which type of ulcer?

Gastric Ulcer

Male pt, 50s, complains of symptoms occuring 30mins-1hr after eating a meal that is relieved by only vomiting. Which type of ulcer may you suspect?

Gastric Ulcer

Which type of ulcer is most often malignant?

Gastric Ulcer

Antibiotics: Aminoglycosides Med Names

Gentamycin, Neomycin, Streptomycin, Tobramycin

What GI Tract infection can you get from containminated water via protozoan?

Giardia lamblia

Antineoplastic: Vinca Alkaloids Nursing Considerations

Give antiemetic before administration Check reflexes Given with Zyloprim to decrease uric acid

Antifungals: Nursing Considerations

Give w food monitor liver function good oral hygiene

Hypoglycemic Agent: Med Name

GlacGen (glucagon)

what meds increase risk of hyperglycemia on PO hypoglycemic agents?

Glucocorticoids Thiazide diuretics Estrogen

Antigout Agents: Uses

Gout

What is frequently present in gastric ulcers?

H. Pylori

-dine

H2 Blocker

What meds would a pt be on for a Hiatal Hernia?

H2 Receptor Blockers (zantac, tagamet) - decrease acid production Antacids (amph, milk of mg) Cytoprotective agents (carafate) coat stomac

Glucose imbalance: ketosis and acidosis do not occur but BG out of range...

HHNK

Which glucose disorder does acidosis not occur thus preventing ketosis?

HHNK

Hormonal agent SE's

HJIMSNVHVSF hypercalcemia jauncdice hunger man or female more sodium and fluid nv hot flashes dryness

-statin

HMG Co-A

stroke positioning

HOB 15-30 to prevent inc ICP

Pyridium Side Effects

Headache, Vertigo, Changes urine orange

Assessment findings of pt with Hiatal Hernia (3)

Heartburn, Dyspepsia, Regurgitation

Anticoagulant Coumadin Side Effects

Hemorrhage, alopecia

#1 birth -3 months, #2 1-4 months, #3 6-18 months

Hep B immunization schedule

Protamine Sulfate

Heparin

Diet for Chron's dx and Ulcerative Colitis?

High Protein High Calorie Low Fat Low Fiber (Baked cod, biscuit w/o butter, fruit roll up) low residue high calorie diet TPN may be needed for bowel rest

Antitumor indications atb #3 chemo

Hodgkin's diseas, Non-hodkings lymphoma Leukemia Many cancers

Insulin: Combination Names

Humulin 70/30

Diuretics Med Names

HydroDIURIL, Aldactone, Lasix, Mannitol

Antihypertensives: Angiotensin II Receptor Blockers Uses

Hypertension, heart failure, MI, diabetic neuropathy, stroke prevention

Antithyroid Agents Uses

Hyperthroidism, myxedema

Hypoglycemic Agent: Uses

Hypoglycemia

Antidiabetic Agents: Side Effects

Hypoglycemia, allergic skin reactions, GI upset

Antihypertensives: Angiotensin II Receptor Blockers Side Effects

Hypotension, dizziness, GI distress

acute renal failure implementation

I/O weights, electrolytes, bedrest IV fluids, diet restrictions

Emergency Care of fractures

Immobilize joint above and below fracture Check temperature, color, sensation, cap refill distal to fracture

Emergency Care for Fracture patient

Immobilize pt with a splint before moving them; Immobilize joint below and above fracture Open fracture- Cover wound with sterile dressings or cleanest material available; Control bleeding by direct pressure Check temperature, color, sensation, cap refill distal to fracture ER- Give narcotic adequate to relieve pain (except in presence of head injury)

what type of meds are used for renal transplant to prevent rejection of new kidney

Immunosuppressive meds

RA and Osteoarthritis

Implementation: Balance rest and activity, medications - analgesics, anti-inflammatory drugs, weight control if obese

signs

In psychopathology, what the clinician observes about a patient's physical or mental condition. See also symptoms.

symptoms

In psychopathology, what the patient reports about his physical or mental condition. See also signs.

As an RN, what do you want to monitor the pt for while being tx for DKA?

Increase ICP! If bg level falls too far or too fast before the brain has time to equilibrate, water is pulled from the blood to the cerebrospinal fluid and the brain, causing cerebral edema and increase ICP

Graves' Disease/Hyperthyroidism Plan

Increased BMR, T3/T4, high titer anti-throid antibodies Keep room cool Avoid stimulants Provide post-thyroidectomy care. Administer antithyroid meds: Methimazole, Propylthiouracil, potassium iodide (SSKI), radioactive iodine.

Thyroid storm

Increaseed Temp and pulse, HTN. Tx: hypothermia blanket, O2, sodium iodine, propylthiouracil (PTU), Inderal, hydrocortisone, Tylenol; also caused by trauma, infection, palpation, RAI (radioactive Iodine) therapy.

Ployromyotomy

Infants w/ployric stenosis incision through circular muscles of pylorus

Osteomyelitis: Data/Diagnose

Infection in bone Data: Pain Swelling, redness, warmth on affected area Fever, leukocytosis (high WBC), Elevated sed-rate (ESR) Positive C&S (culture and sensitivity) Xray of Affected Part Diagnose: Infection of the bone/marrow caused by Staphylococcus aureas, carried by the blood from a primary site of infection or from direct invasion (e.g. orthopedic procedures or Fractures). Risk Factors: a. Poorly nourished b. Elderly c. Obesity d. Impaired Immune System e. Long-term corticosteroid therapy

Antacids Nursing Consideration

Interferes with absorption of antibiotics, iron preps, INH, oral contraceptives Monitor bowel functions

Chemo 1 Antienoplastic- Alkylating Agent (action)

Interferes with rapidly producing cell dan

What is the first step during an intestinal obstruction?

Intestinal decompression & NPO status insertion of a plastic or rubber tube into the stomach via intestine via the nose/mouth. Purpose may be to dx preventive, or therapeutic. fluid or air may be removed types: NG tube (salem sump/levin) Intestinal tube (Miller-Abbot or Cantor)

Cast exercises ?

Isometric exercises- contraction of muscle without movement of joint --Maintains strength while in cast --Quadriceps setting- push back knees into bed --Gluteal setting- Push heels into bed

assess hepatitis

Jaundice, anorexia, clay-colored stool, tea urine, itching,

Antidiarrheals: Med Names

Kaopectate, Lomotil, Imodium, Paregoric

Pavlik Harness

Keeps femur in acetabulum (4-5mon). Worn 24 hrs a day. Adjust every 2 weeks because of rapid growth.

What type of ostomy is a continent ileal reservoiir?

Koch pouch

EDB August 22, 2013

LMP = november 15 2012, Naegles rule

common Hallucinagenics....

LSD, PCP

Cardiac Glycosides Med Names

Lanoxin (digoxin)

Chronic Pain

Lasts 6 months or longer. Causes fatigue, depression, immobility

Acute Pain

Lasts split second up to 6 months. Causes decreased healing, changes in vital signs

What time should you advice your DM pt to shop for shoes and why?

Later in the day, greatest time foot swells -

Scoliosis

Lateral curvature of vertebral column

ET3- Malaginacies correlated with physical factors

Leukemia Lypmhona Thyroid cancer Bone cancer Lung Cancer (asbestos-related)

Huntington meds aimed at reducing movt. and subduing behavior

Librium, Haldol, Thorazine

Antianxiety Med Names

Librium, Xanax, Ativan, Vistaril, Equanil

Antidysrhythmics Side Effects

Lightheadedness, hypotension, bradycardia, urnary retention

Bipolar Disorder: Med Names

Lithium (salt), Tegretol (mood stablizer), Depakote (mood stablizer)

psychosis

Loss of contact with reality, most often evidenced as delusions or hallucinations.

Data Collection Herniated Intervertebral Disk

Low back pain (knifelike) Lack of muscle tone Poor posture or body mechanics Sensory changes

Post thyroidectomy care

Low or semi-fowler's position Support head, neck, and shoulders to prevent flexion or hyperextension of suture line. Tracheostomy set at beside Give fluids as tolerated Observe for complications: Laryngeal nerve injust (detected by hoarseness), Thyroid Storm, Hemorrhage, Respiratory obstruction, Tetany (decreased Ca from parathroid involvement)-check Chvostek's and Trousseau's signs. Analgesics, cold steam inhalations for sore throat Adjust diet to new metabolic needs

measles, mumps, rubella

MMR stands for

Antacids Med Names

MOM, Maalox, Amphojel

example of contact precautions

MRSA

Casting

Made from plaster or fiberglass (lighter, stronger, water-resistant, porous) Immediate care: --avoid covering cast until dry (48 hrs or longer) --Handle w/ palms not fingertips --Keep affected limb elevated above heart on soft surface until dry Intermediate care: --If fiberglass cast gets wet, dry with hair dryer on cool setting After-cast care: --Swelling is common --Elevate limb and apply elastic bandage

Calcium gluconate

Magnesium

Traction Care

Maintain straight alignment of ropes and pulleys Assure that weights hang free Frequently inspect skin for breakdown areas Maintain position for countertraction Encourage movement of affected areas Investigate every complaint immediately and thoroughly Maintain continuous pull Clean pins with half-strength peroxide or saline and sterile swabs 1-2 times a day if ordered

Positive outcomes of mobility

Maintains joint mobility and function Increases muscle strength Maintains circulation and ventilation Increases appetite and maintains elimination Increase metabolic rate

Bipolar Disorder: Uses

Manic episodes

Antidepressants: MAOIs Med Names

Marplan, Parnate, Nardil

Antihypertensives: Beta Blockers Nursing Considerations

Masks signs of shock and hypoglycemia Take with meals Do not dc abruptly

Hypoglycemic Agent: Nursing Considerations

May repeat in 15 min Give carbs orally to prevent secondary hypoglycemic reactions

Assistive Devices: Crutches

Measure 2 fingers below axilla, support weight on hands, position crutches 8-10 in out to side, flex elbows 20-30 degrees Stairs: go up with the good, down with the bad

child <2yrs presents with painless rectal bleed and jelly-like stool ...what may you suspect?

Meckel's Diverticulum

which type of tube removes fluid/gas intenstine?

Miller abbot

What drug would you advice a pt with a ostomy to avoid?

Miralax

Andrenergics Nursing Considerations

Monitor B/P, Monitor Peripheral Pluses, Check Output

Bronchodilators Nursing Considerations

Monitor BP and HR When used with steroid inhaler, use bronchodilater first May aggravate diabetes

Atypical Antipsychotic Agents Nursing Considerations

Monitor Blood Work Chang position slowly Use sunscreen Monitor VS - Airway

Antitussive Agents Nursing Considerations

Monitor Cough Avoid alcohol

Antipyretic Nursing Considerations

Monitor LFT & ALT Aspirin contraindicated under 21 yo due to risk of Reye's syndrome

Anticoagulant Coumadin Nursing Considerations

Monitor PT Normal 9-12 sec Therapeutic level 1.5 times control Antagonist- Vit K Monitor for bleeding Give PO

Antineoplastic: Antitumor Nursing Considerations

Monitor VS Give antiemetic before administration

Antidysrhythmics Nursing Consideration

Monitor VS and Cardiac Rhythm

Anticoagulant Heparin Nursing Considerations

Monitor clotting time or PTT Normal 20-45 sec Therapeutic level 1.5-2.5 times control Antagonist- protmaine sulfate Give SC or IV - Do NOT aspirate or Massage!

Glucocorticoids Nursing Considerations

Monitor fluid and electrolyte balance Don't dc abruptly Monitor for signs of infection

Electrolytes Nursing Considerations

Monitor fluid and electrolyte levels

Thrombolytics Nursing Considerations

Monitor for bleeding Have amino caproic acid available - Antidote Check pulse, color, sensation of extremities Monitor EKG

Antidepressants: Tricyclics Nursing Considerations

Monitor for suicide takes 2-6 weeks to work take at bedtime monitor vital signs position slowly wean off medication no alcohol no sun- use sunscreen

Carbonic Anhydrase Inhibitors Nursing Considerations

Monitor for systemic effects

Antiparkinson Agents Nursing Consideration

Monitor for urinary retention Large doeses of Vit B6 reverse effects Avoid use of CNS depressants

Attention Disorder Agents Nursing Consideration

Monitor growth rate Monitor liver enzymes Give in am

Antineoplastic: Antimetabolites Nursing Consideration

Monitor hematopoietic function Good mouth care Discuss body image changes

Anticholinergics Nursing Considerations

Monitor output Contraindicated with glaucoma Give 30 min before meals, at bedtime or 2 hours after meals

Thyroid Replacement Agents Nursing Consideration

Monitor weight Take in am Monitor pulse and BP Enhances antideppresants and anticouglant stronger Decreases insulin and digoxin

the narcortics that r most often abused are...

Morphine, Codeine, Heroin, dilaudid and demoral

Narcotics Med Names

Morphione, Codeine, Demerol, Dilaudid, Precodan (oxycodone)

NSAIDS Med Names

Motrin, Indocin, Naprosyn

Alkylating agent #2 Leukeran SE's

N, V, bone marrow depression, depression, and sserility

Antimetabolites side effects

N-nausea and vomiting D-diareheaa O-oral ulceration H-hepatic dysfunction B-bone marrow suppression R-renal dysfunction Alpoceia

what two orders would you suspect the pt to be on post op ostomy

NG tube until peristalsis returns NPO status

Insulin: Intermediate Acting Names

NPH Humulin N

#1 RN action for gastritis

NPO (must rest stomach) then bland diet progression

Tx of HHNK

NS or 0.45% NaCL Regular insulin IV Potassium as soon as UO is adequate

Antianginals Med Names

Nitro, Isordil

Depakote - Anticonvulsant

No carbonated beverages

Antineoplastic: Hormonal Agents Med Names

Nolvadex, Testosterone

Andrenergics Med Names

Norepinephrine, Dopamine, Epinephrine, Dobutamine

Immobility: Hypercalcemia

Normal Ca: 8.5-10 Assessment: Impaired bone growth Implementation: Reduce calcium in diet, encourage fluids

Spina Bifida/Neural Tube Defects:Plan/Tx

Occulta: no Tx Meningocele/myelomeningocele: Surgical repair at 24-48 hours. Observe for irritation, CSF leakage and signs of infection, hydrocephalus. Maintain optimum asepsis; cover lesion with MOIST sterile dressing. Position patient on ABD or semiprone (on side, top knee up) with sandbags. Provide optimum skin care, especially to perineal area. Check for ABN movement of extremities, absent or ABN reflexes, incontinence, fecal impction, flaccid paralysis of lower extremities. Observe for increased intracranial pressure (h/a, changes of LOC, motor functions, and vital signs). Observe for symptoms of meningeal irritation or meningitis. Provide frequent sources of stimulation appropriate for child's age level. Provide postoperative care - vertebral fusion or surgical repair. Focus postoperative observation on detecting signs of meningitis, shock, increased intracranial pressure, and respiratory difficulty. Foster parental bonding. Reinforce family teaching on how to care for child at home. Discuss with family referral for PT, orthopedic procedures, bladder and bowel management.

Sleep Apnea Syndrome Diagnoses

Occurs in older, overweight men, elderly, people with thick necks, smokers. Polysomnography (PSG)-EEG, EMG, ECG, oxygen saturation levels; diaphragmatic movememnt monitored during sleep. Types: Obstructive=lack of airflow due to occlusion of pharynx Central=cessation of airflow and respiratiory movements Mixed=combination of central and obstructive apnea within an episode.

Osteoprosis

Occurs in postmenopausal women Prevention Safety issues Assessment: reduction in bone mass, decreased height, low back pain, kyphosis Risk factors: over 60 years old, small frame, caucasian or asian, postmenopausal, use of alcohol, smoking, sedentary lifestyle d/t lack of weight bearing on the bones Implementation: diet high in calcium, protein, vitamin D, estrogen replacement therapy, med: FOSAMAX, safety precautions to prevent fractures

What is a hiatal Hernia?

Opening in diaphragm thr which the esophagus passes becomes enlarged, part of the upper stomach comes up into the lower portion of the thorax. aggervating factor = increase ab pressure (pregnancy, obesitiy, ascities)

Hydrocephalus:Plan/Tx

Operative management: Ventriculoperitoneal shunt: connection between ventricles and peritoneal cavity. Ventricular atrial shunt: connection between ventricles and right atrium. Ventricular drainage: provides external drainage of fluid. Observation of shunt functioning. Observe for increased intracranial pressure and for signs of shunt infection (irritability, high pitched cry, lethargy). Postoperative positioning-on unoperated side in flat position; do no hold infant with head elevated. Shunt needs to be modified as child grows. Continual testing for developmental ABN/mental retardation. D/C planning teaching/referral Teach parents about increased risk allergies if myelomeningocele present

Narcan

Opiates

Electrolytes Med Names

Os-Cal, Slow Mag, K-Dur, Sodium Chloride

Hyperparathyroidism Diagnose

Oversecretion of parathroid hormone Benign parathyroid tumor Parathyroid carcinoma Neck trauma Neck radiation Diagnostic tests: increased serum calcium and serum parathyroid hormone (PTH), decreased serum phosphorus. X-ray:bones appear porous.

Pain History PQRST

P- precipitating factors Q- quality R- region/radiation S- severity T- timing

pneumococcal PCV

PCV stands for

-prazole

PPI

Rheumatoid/Juvenile Rheumatoid Arthritis(JRA): Tx/NC

Pain management, rest, activity, exercise. Weight control if obese. Heat (e.g., warm tub baths; warm, moist compresses; paraffin dips) Splints for joints. Analgesics, anti-inflammatory drugs. Disease modifying antirheumatc drugs (DMAD) Immunosuppressive drugs Antitumor necrosis drugs

Osteoarthritis: Tx/NC

Pain management, rest, activity, exercise. Weight control if obese. Analgesics, anti-inflammatory drugs, Heat application.

Gout: Tx/NC

Pain management. Diet: avoid meats rich in purines (organ meats, sardines, fish, legumes, yeast), alcohol, ketoacidosis (high ketones), dehydration. Analgesics (ASA) Medications for Gout.

Antiparkinson Agents Uses

Parkinson's Disease

Antidepressants: SSRIs Med Names

Paxil, Prozac, Zoloft

hallucinations

Perceived experiences that occur in the absence of actual sensory stimulation.

A client is in balanced suspension traction and reports pain in the affected extremity 1 hr after receiving pain medicine.

Perform a neurovascular assessment. Pain unrelieved by medication is a sign of acute compartment syndrome.

Active Resistive ROM

Performed by client against resistance 5 lb weights used Increases muscle power

Active ROM

Performed by client without assistance Maintains mobility of joints

Isometric Exercises

Performed by the client Alternate contraction and relaxation of muscle Joint remains immobile Maintains strength of muscle when joint is immobilized

Active Assistive ROM

Performed by the client with assist by RN Increases motion in joint

Structural Scoliosis

Permanent, fixed; hereditary deviation.

Antianxiety Nursing Considerations

Potential for addiction/overdose, Avoid Alcohol, Monitor LFT

Passive ROM

Preformed by the RN Maintains joint movement and circulation

inc ICP nrsg

Prevent valsalva (tell pt to exhale while turning or moving in bed), stool softeners, restrict fluid 1200-1500. meds: osmotic diuretics, cortico, antiseizure

Anticholinergics Med Names

Pro-Banthine, Atropine, Scopace

Muscular Dystrophy: Tests/Tx

Progresive muscular weakness, atrophy of voluntary muscles (no nerve effect). Etiology:genetic Diagnostic tests: CPK (creatinine phosphokinase), ABN EMG, ABN muscle Biopsy. Progressive to terminal Tx: Intensive PT, active and passive stretching and ROM. Light spinal braces or long leg braces may help ambulation. Promote safety to slips/falls Prevent contractures Discuss balance between activity and rest for the child

Amyotrophic Lateral Sclerosis (ALS)

Progressive, degenerative disease involving the lower motor neurons of the spinal cord and cerebral cortex; the voluntary motor system is particualarly involved with progressive degeneration of the corticospinal tract, leads to a mixture of spastic and atrophic changes in cranial and spinal musculature.

S/S in pyloric stenosis infants

Projectile vomiting palpable olive-shaped tumor in epigastrium irritability infant ALWAYS hungry but fails to gain weight peristatic waves

Halo Fixation Device (vest)

Provides immobilization of cervical spine; pins are used to maintain traction; care of insertional site includes cleansing area around pins using sterile technique. If prescribed by physician, clean with half-strength peroxide or saline and sterile swabs 1-2 times/d

Antibiotics: Aminoglycosides Uses

Pseudomonas, E. coli

Traction

Purpose: --Reduce the fracture --Alleviate pain & muscle spasm --Prevent or correct deformities --Promote healing Types of traction: Buck's, Russell's, Cervical (skull tongs), Balanced suspension, Halo fixation device (vest) Care: -- Maintain straight alignment of ropes and pulleys --Assure that weights hang free --Encourage movement of unaffected areas --Investigate every complaint immediately and thoroughly --Maintain continuous pull --With order, Clean pins 1-2 times a day (1/2 strength peroxide or saline & sterile swabs)

Russell's traction

Purpose: "pulls" contracted muscles Treatment: --Elevate foot of bed with shock blocks to provide countertraction --Sling can be loosened for skin care --Check popliteal pulse --Pillows under lower leg; Heels off the bed --Life client, not leg, to provide assistance ** Must not turn from waist down

Cervical (skull tongs) traction

Purpose: Realigns fracture of cervical vertebrae and relieves pressure on cervical nerves Treatment: ** Never lift weights- traction must be continuous ** No pillow under the head ever; beware during feeding, suction may be needed

Balanced suspension traction

Purpose: Realigns fractures of the femur; Uses pulley to create balanced suspension by countertraction to the top of the thigh --Thomas splint w/ Pearson attachment

Buck's traction

Purpose: Relieves muscular spasm of legs & back Treatment: --With fracture, turn pt to unaffected side --Elevate foot of bed for countertraction --Use trapeze for moving --Pillow beneath lower legs, not heels

If you pt states epigastric fullness, what may you assess for?

Pyloric Stenosis

Antihyperlipidemic: Med Names

Questran, Lipitor

4.6-6.2 = man

RBC man

4.2-5.4 = woman

RBC woman

Assistive Device: Hoyer lift

Raise and lock the bed, center straps under patient's shoulder and knees, lower arm and attach hook, one person guides the lift, another person assists the client

with Chronic Alcohol Dependence is a very predictive defensive style

Rationalization, projection and denial

Cervical (skull tongs)

Realigns fracture of cervical vertebrae and relieves pressure on cervical nerves; never lift weights- traction must be continuous. No pillow under the head during feeding; hard to swallow, may need suctioning

Balanced suspension

Realigns fractures of the femur; uses pulley to create balanced suspension by countertraction to the top of the thigh splint. Thomas splint (positioned under anterior thigh) with Pearson attachment (supports leg from knee down) frequently used.

obsessions

Recurrent unwanted or disturbing thoughts. See also compulsions, obsessive-compulsive disorder.

Insulin: Fast Acting Names

Regular - can be given IV or Pump Humulin R

Besides fluid resistation on diabetic ketoacidosis, what other meds would you admin?

Regular insulin IV 5 units/hr Potassium replacement (will be hypokalemic)

Multiple Sclerosis:Tx

Reinforce relaxation and coordination exercises Teach Progressive resistance exercises, ROM Encourage fluid intake 2000mL/day Administer medications:immunosuppressants, corticosteroids, antispasmodics, interferon beta-1a, monoclonal antibodies. Wide-based walk, use of cane or walker Use weighted bracelets and cuffs to stabilize upper extremities Bladder and bowel training (care of Foley catheter if appropriate) Self-help devices Eye patch for diplopia NO TETRACYCLINE OR NEOMYCIN because they increase muscle weakness with MS. Occupational Therapy Provide emotional support Referrals- National Multiple Sclerosis Society

personality disorders

Relatively stable, pervasive patterns of behavior and inner experience that are culturally discrepant and lead to distress or impairment; noted on Axis II of the DSM.

Hyperparathyroidism Tx

Relieve pain Prevent formation of renal calculi, increase fluid intake Offer acid-ash juices (improves solubility of calcium) Administer appropriate diet Prevent Fx Monitor K+ levels (counteracts effect of calcium on cardica muscles) Provide postparathyroidectomy care (essentially same as for throidectomy). IV Lasix and saline promote calcium excretion IV phosphorus is used only for rapid lowering of calcium level. Surgery-parathyroidectomy.

Buck's Traction

Relieves muscular spasm of legs and back; if no fracture, may turn to either side; with fracture, turn to unaffected side. 8-20 lb used; 40lb for scoliosis. Elevate foot of bed for countertraction. Use trapeze for moving, Place pillow beneath lower legs, not heel. Don't elevate knee gatch

compulsions

Repetitive or ritualistic acts that, in OCD, serve in some way to deal with the obsessions. See obsessions, obsessive-compulsive disorder.

what type of surgery may be performed for a bowel obstruction?

Resection & Anastomosis (diseased portion of bowel removed and remaining ends are joined together) Abdominal perineal resection (perm colostomy)

Anticonvulsants Side Effects

Respiratory depression, aplastic anemia, gingival hypertrophy, ataxia

Transverse colostomy (return, oder, drainage, appliance)

Return: soft to fairy firm odor: VERY foul drainage: irritatating appliance: worn at ALL times

McBurney's Point is located where?

Right lower quad between umbilicus and the right iliac crest

Attention Disorder Agents Med Names

Ritalin, Dexedrine

Myexedema/Hypothyroidism S/Sx and Tx

S/Sx: Decreased activity, sensitivity to cold, obesity, weight gain, constipation, alopecia, bradycardia, dry skin/hair. Tx:Hormone replacement (Synthroid, Levothyroid)

Graves' Disease/Hyperthyroidism S/Sx and Tx

S/Sx: Hyperactivity, Sensitive to heat, weight loss, diarrhea, tachycardia, exophthalmus, fine, soft hair Tx: Antithyroid drugs (SSRI methimazole, propylthiouracil), Irradiation, surgery.

Narcotics Nursing Considerations

Safety precautions Avoid alcohol Monitor VS Narcan

Immunosuppressants Med Names

Sandimmune (cyclosporine)

Antianxiety Side Effects

Sedatiosn, confustion, hepatic dysfunction

Antihypertensives: Alpha 1 Adrenergic Blockers Actions

Selective blockade of alpha-1 reception in peripheral blood vessels

Hypertensive Crisis

Severe Headache Palpitations Diaphoretic Stiff Neck

what GI infection is caused from fecal contamination and affects the pediatric population?

Shingella

Teaching regarding meals, position, etc for hiatal hernia? (3)

Small, freq meals Do not lie down for 1hrs after meals elevate HOB 4-8in when sleeping do not eat before going to bed

Osteomalacia

Softening of the bones due to a lack of vitamin D or a problem with the body's ability to break down and use this vitamin. Data: Bone pain and tenderness, Muscle weakness, bowed legs, Kyphosis, X-ray (porous bones). Diagnose: Decalcification of bones due to inadequate intake of Vit D, absence of exposure to sunlight, or intestinal malabsorption, chronic kidney disease/ Plan: 1. Administeration of analgesics 2. Increase sun exposure 3. Reinforce about Vit D foods (milk, eggs, Vitamin D enriched cereal/bread) 4. Administer Vitamin D, calcium, and expose to sunlight and/or ultraviolet irradiation. 5. Assist with performance of ADL to prevent pathological fractures.

Glucocorticoids Med Names

Solu-Cortef (hydrocortisone) Decadron, Prednisone

_____normal or elevated BG levels present at bedtime. hypoglycemia occurs about 2-3am but by 7am (in resp to counter-reg hormones) pt is hyperglycemia. What is its tx?

Somogyi Phenomen TX: decrease evening (predinner/bedtime) dose of NPH or increase bedtime snack

Spina Bifida

Spina Bifida is a NTD (neural tube defect) and is associated with low folic acid in mother's diet Spina Bifida Occulta: dimpling at the site or skin depression, port-wine angiomatous nevi, dark tufts of hair, soft, subcutaneous, lipomas, Meningocele: Sac like lesion filled with spinal fluid Myleomeningocele: Sac like lesion includes spinal fluids and spinal cord element Lamine of the vertebrae are gone. Implementation: - Cover lesion with moist sterile dsg - Position on abdomen or semi prone - Observe for symptoms of IICP - Observe for meningitis - Surgical repair at 24-48 hours - Observe for shock and respiratory difficulty

about trigeminal neuralgia (tic douloureux)

Stabbing/burning facial pain, unpredictable. Trmt: avoid stimuli, carbamazapine (Tegretol), ETOH inject to nerve, resection of nerve, microvascular decompression, chew on opposite side of mouth

Andrenergics Actions

Stimulates Beta-2 Receptors in Lungs (causes brochdilation)

Antidiabetic Agents: Actions

Stimulates insulin release from beta cells in pancreas

Assistive Device: Cane

Straight and quad cane. Flex elbow 30 degrees, have cane on good side to balance

Thrombolytics Med Names

Strepokinase, Urokinase, Tissue Plasminogen Activator (TPA)

Therapeutic Position

Supine: avoids hip flexion Prone: extension of hip joint Side lateral: drainage of oral secretions Fowler's: Increase venous return, lung expansion (subtract 15 degrees - High Flower's - 60-90 - Fowler's- 45-60 - Semi- Fowler's - 30-45 - Low Fowler's - 15-30 Modified Trendelenburg: used for shock, elevation of extremity increases blood to extremity and venous return (increases BP) - Feet elevated 20 - Knees straight - Head slightly elevated

what test is done to dx cystic fibrosis? what are norm values/dx?

Sweat Cl-test norm <40 dx: >60

Thyroid Replacement Agents Med Names

Synthroid, Cytomel

delusions

Systematized false beliefs, often of grandeur or persecution.

Antitubercular Agents Uses

TB, to prevent disease in person exposed to organism

toxoplasmosis(cats), Other, rubella, cytomegalovirus, herpes

TORCH stands for

post-op management after TEF?

TPN, gastrostomy, until oral feedings can be tolerated

H2-Receptor Blockers Med Names

Tagamet, Zantac

Antibiotics: Tetracyclines Nursing Consideration

Take 1 h before or 2-3 after meals Do not take antacid, mile, iron SUNBLOCK - avoid sunlight Monitor renal function Note Expiration Date - Toxic after date

Antibiotics: Macrolide Nursing Consderations

Take 1 h before or 2-3 h after meals Monitor LFT Take w full glass of water

Cytoprotective Agents Nursing Considerations

Take 1h before food Give 2h becofe or after other meds

Cardiac Glycosides Nursing Consideration

Take apical pulse Notify physician if adult <60, child <90-110 Monitor potassium level (3.5-5)

Antihyperlipidemic: Nursing Considerations

Take at bedtime or 30 mins after meals Administer 1 h before or 4-6h after other meds

Iron Preparations Nursing Considerations

Take on empty stomach Vit C increases absorption Monitor Hct and Hgb

Immunosuppressants Nursing Considerations

Take once daily in am Used with adrenal corticosteroids Monitor renal and liver function tests Take w milk or juice Stay away from sick ppl Good Handwashing

Antibiotics Teaching

Take until gone Do culture and sensitivity first Encourage fluids Check expiration date

Antibiotics: Cephalosporins Nursing Consideration

Take w food Cross allergy with PCN Avoid alcohol Obtain Culture and Sensitivity before first dose

NSAIDS Nursing Considerations

Take w food or after meals Monitor liver and renal functions Use cautiously with aspirin allergy Check for bleeding

H2-Receptor Blockers Nursing Considerations

Take w meals and hs Smoking decreases effectiveness Monitor LFT and CBC

Diuretics Nursing Considerations

Take with food or milk Take in am Monitor fluid and electrolytes

Antibiotics: Sulfonamides Nursing Considerations

Take with meals Encourage fluids Good mouth care

Pyridium Nursing Considerations

Taken with meals Urinary tract analgesic

Antithyroid Agents Med Names

Tapazole, SSKI

Hypoparathyroidism S/Sx

Tetany (involuntary contraction of muscles), muscle irritability (cramps/spasms), dysphagia, paresthesia, laryngeal spasm, anxitey, depression, irritability, tachycardia,Chvostek's and Trousseau's signs.

prognosis

The forecast of how a situation (including an illness) will improve or fail to improve in the future.

somatogenic hypothesis

The hypothesis that mental disorders result from organic (bodily) causes.

psychogenic hypothesis

The hypothesis that mental disorders result from psychological causes.

learning model

The hypothesis that mental disorders result from some form of faulty learning.

dissociative amnesia

The inability of an individual to remember some period of her life, or even her entire past, including her identity; often understood as a way of coping with extremely painful events.

Diagnostic and Statistical Manual for Mental Disorders (DSM)

The manual that provides specific guidance on how to diagnose each of the nearly 200 psychological disorders; currently in its fourth edition, text revision (DSM-IV-TR).