med surge test 3- integumentary, burns, lower respiratory problems, obstructive pulmonary diseases

photosensitivity and drugs -the manifestations of drug induced photosensitivity are those like a? these include? -what do you teach pts who are using a photosensitive drug?

-what are the drugs that have photosensitivity in the drug classes- antidepressants- antidysrhythmics- antihistamines- antimicrobials- antifungals- antipsychotics- chemotherapy- diuretics- hypogylcemics- nsaids-

Non-melonoma skin cancers -they are the most...? Consist of? -the develope in the? Develope on which parts of the body? -there are very few.... but they have the potential for? -Squamous cell cancers usually occur? -basal cell cancers...? usually occurs in which people?

Basal cell Carcinoma -what is it? is the most....? etiology and patho -change in... no...? -continuing division....? -related to? clinical manifestations -nodular and ulcerative-small. borders...erosion..normal..? -superficial-erythematous...? treatments and prognosis -Surgical.... -for metastatic or recurrent locally invasive lesions? -for superficial lesions? -slow... -metastasis rare,....? -what is needed to confirm the diagnosis?

COPD clinical manifestations -the manifestations of COPD typically develop? -pts may report...? -in the later stages of COPD, what may be present at rest? -the person with advanced COPD often has? -during physical examination a prolonged what is observed? Decreased....and/or.... are ascultated in all lung fields? -because the anteroposterior diameter of the chest is increased (barrel chest) from the chronic air trapping, the pt may need to....for breath sounds to be heard in the stethoscope. -the pt may sit....with arms....which is known as the?

COPD diagnostic studies - a diagnosis of COPD is made when the? -chest x rays are not diagnostic but often show? -a physical or respiratory therapist may do a? -if values of O2 saturation are 88 or lower when at rest and the pt is breathing room air they qualify for? -in the later stages of COPD typical findings are low-normal? high-normal or above normal? and a high-normal?

COPD -is a .... characterized by? -is associated with...and primarily caused by?

COPD risk factors -cigarette smoking-COPD should be considered in any person who is over the age of....and has? -infection- what in childhood has been associated with reduced lung function and increased respiratory symptoms in adulthood? -asthma- symptoms can? -air pollution- high levels of... are harmful to people with existing lung disease? -occupational chemicals and dust- if a person has intense or prolonged exposure to various....in the workplace, symptoms of lung impairment consistent with COPD can develop? -aging-normal aging results in...? the lungs gradually lose their? the thoracic cage becomes...and the ribs are? the number of...decrease as?

viral infections -are...? when a virus infects a cell what can develope?- these can also result from a what response to a viral infection? what are the most common viral infections affecting the skin?

Herpes simplex virus (HSV) types 1 and 2 etiology and patho -what infections are serotyped as either HSV 1 or 2? they are? -worsened by? -contagious to those? -transmitted by? -infections in one area readily? clinical manifestations -first episode- symptoms occuring? painful? singled or grouped? Systemic symptoms? -recurrent- recurrence in? characteristic? treatment and prognosis -symptomatic -soothing...? -scaring...? -antiviral agents such as? -vaccine?

pneumonia interprofessional care -what is used to prevent S. pneumoniae infection? -prompt treatment with... is essential? -In uncomplicated cases pts respond to abx therapy within? signs of improvement include? abnormal physical findings can last more than?- a repeated... may be done in... to assess for a resolution? -viral pneumonia currently has no? in most circumstances viral pneumonia is... and will resolve in? antiviral therapy may be used if the pneumonia is caused by? Drug therapy -for all types of pneumonia .... is based on whether the pt has risk factors for? clinical improvement usually occurs within? IV abx therapy should be switched to.... as soon as the pt is? Nutritional therapy -what is important in the supportive treatment of pneumonia which is to prevent? -what is easier for dyspneic patients to tolerate? offer foods that are high in?

Nursing implementation of pneumonia -to reduce the risk for pneumonia teach pts to practice good health habits such as? what is one of the most important health promoting behaviors? -place the pt with altered consciousness in.... that will prevent or minimize the risk for? turn and reposition pts every.... to promote? -for the pt who has difficulty swallowing and needs aid in eating, drinking, and taking medication to prevent aspiration, elevate the hob at least.... and have the pt? -encourage pts to?

acute phase- laboratory values -hyponatremia can develop from excess? manifestations include? the pt may develop dilutional hyponatremia called.... from? to avoid this condition offer the pt? -Hypernatremia may occur after? hypernatremia may also be caused by ? manifestations include changes in? sodium restrictions may be applied to? -hyperkalemia may occur if the pt has? -hypokalemia occurs with?

acute phase complications- infection -infection can convert? -watch for signs and symptoms of infections which include? -the causative organisms of sepsis are usually... putting the pt at further risk for?

acute phase -when does the acute phase begin? It ends when? This may take? -what returns? -the depth of the wounds may become more.....? -the pt may now become more aware of the enormity of the situation and will...? -necrotic tissue begins to? -a partial thickness burn will heal from both...if...? however full thickness burns unless extremely small must have the burn.....? in some cases, healing time and the length of hospital stay are?

acute phase-clinical manifestations -partial thickness wounds form... which begin? once it is removed...? -full thickness wounds require what to heal?

asthma -is... disease characterized by.... with? -signs and symptoms often include? risk factors and triggers for asthma -nose and sinus problems- most pts with asthma have a history of? acute and chronic sinusitis especially bacaterial rhinosinsutis may? -genetics-.... the genetic predisposition to develop an allergic response to common allergens is a? -immune response- what suggest that a new born baby's immune system must be conditioned so that it will function properly during infancy and the rest of its life? people who have a lower incidence of asthma were....? -allergens-can be? -excercise- asthma that is induced or worse during physical exertion is called...or? symptoms of EIA are pronounced? EIB occurs? -air pollutants- various air pollutants such as....can trigger asthma attacks? -cigarette smoking- in a person with asthma smoking is associated with? -occupational factors- these irratants cause a? however these symptoms? -respiratory tract infections- are often a major trigger of an acute asthma attack, in which acute infection can cause? -drugs and food additives- some people with asthma have what we call...which includes....to? these may cause an asthma attack because they can cause bronchospasms? may cause a dry hacking cough is susceptible pts, making symptoms worse? food and drugs additives that may trigger asthma in the susceptible pt is? -GERD- can worsen asthma symptoms because reflux may trigger? -psychological factors-symptoms may worsen with? Extreme behavioral expressions can lead to.... which can cause?

asthma pathophysiology -the main pathophysiological process in asthma is? airflow is limited because inflammation results in? -inflammatory mediators have effects on the? this whole process is known as the...clinically it occurs within...after exposure to an allergen or irritant? -symptoms can recur up to...after the early response because of the...which are in set by the initial inflammatory response? at this later time, the pt may develop...this is called the? bronchoconstriction can occur up to...in this phase and .... are effective in treating inflammation in this phase?

folliculitis etiology and patho -usually? -present in areas subjected to? -increased incidence in pts with? clinical manifestations -small pustule at? -development of? -most common on the? -tender to? treatment and prognosis -antistaphylococal soap such as? and? -topical? -warm compress of? -usually heals without? -if lesions extensive and deep...?

cellulitis etiology and path -inflammation of the? -may be a? -often follows a? -what are usually the causitive agents? -what occurs from the enzymes produced by bacteria? clinical manifestations -hot.....? -chills...? treatment and prognosis -topical? -systemic?

chest surgery pre op care? -assess the pts....to determine their ability to tolerate the surgery and provide a baseline reference for postoperative care? -diagnostic studies may include? -the pt should be in the best? and if applicable stop? -teach the pt what to expect after surgery, include the use of? reassure the pt that adequate medication will be used to reduce?

chest surgery-thoracotomy -is a surgical incision into the chest to gain access to? -two common approaches to a thoracotomy is? -which one involves splinting the sternum and primarily is used for surgeries involving the heart. -which one involves an incisions such as posterolateral or anterolateral incision for surgeries involving the lungs. the incision is made from the front to back at the level of the 4,5,6 intercostal space.

classification of burns-extent of the burn what are ten rules for the criteria for pts being refferaled to a burn center? -what are two common tools used for determining the TBSA affected or the extent of the burn? -which one is more accurate bc it considers the pts's age in proportion to relative body area size? -which one can be used for an initial assessment because it easier to remember?

classification of burns- location of the burn -which burns may interfere with breathing? Because why? These burns may indicate possible? -Burns to the hands, feet, joints, and eyes are of concern because...? Burns to the hands and feet are challenging because of? -burns to the ear and nose are at risk for..... because? -burns to the buttocks or perineum are at high risk for infection from?

the 3 types of smoke and inhalation injuries -metabolic asphyxiation-most deaths at a fire scene are the result of inhaling? oxygen delivery? death can occur? CO and hydrogen cyanide poisoning may occur? -upper airway injury- results from inhalation injury to the? what can be massive and have a rapid onset? burns to the? what can be lethal? what can occur quickly presenting a true airway emergency? what are the manifestations of upper airway burn injury (7)? -lower airway injury- inhalation injury to the... is usually caused by breathing? tissue damage is related to the? carefully assess the pt for? pulmonary edema may not appear until... then it may manifest as?

classifications of burns-depth severity is determined by which 4 factors? -depth of burn-what 2 terms are used to determine the depth of a burn? when significant damage occurs with a full-thickness burn, not enough... and a permanent...?-look at table 24.5

pulmonary embolism -is the blockage of? by? -most PE's arise from? -saddle embolus refers to a large thrombus? -risk factors for PE include?

clinical manifestations of PE -small emboli may go? or cause -symptoms may begin? -what is the most common presenting symptom occuring in 85% of pts with PE? -mild to moderate what may occur? -other manifestations may include? -massive PE may cause a sudden change in?

pathophysiology of lung cancer -Most primary lung cancers are thought to arise from? -these cells are slow growing taking.... to reach? -lung cancers primarily occur in the.... and the? -primary lung cancers are categorized into 2 broad sub types?

clinical manifestations of lung cancer -manifestations of lung cancer are usually.... and appear? -the common symptom and often the one that is reported first is a? the pt may also report? -later manifestation include nonspecific.... such as?

pleural effusion -is an abnormal collection of? it is a...but is a sign of? -fluid accumulation can be due to? types of effusions -occurs primarily in noninflammatory conditions. It is an accumulation of? the fluid is? these effusions are caused by? -results from increased capillary permeability due to an inflammatory reaction? they most often occur with an?

clinical manifestations of pleural effusion -what may show decreased movement of the chest on the affected side, dullness to percussion, and decreased breath sounds over the affected area? -what may reveal the volume and location of the effusion?

clinical manifestations -the areas of full-thickness and deep-partial thickness are at first ..... bc? superficial to moderate partial burns are? what is common in partial thickness burns? -the pt with larger burns may develop a? -what may occur because of chilling that is caused by? -what usually occurs from hypoxia associated with smoke inhalation?-other possibilities include?

complications of the emergent phase cardiovascular system- complications include? these if untreated can lead to? what can be severely impaired by deep circumferential burns and subsequent edema formation, which act, like a tourniquet? - if untreated what can occur? what is often done to restore circulation to compromised extremities of improve chest expansion? -initially...bc of the fluid loss. microcirculation is impaired bc of the?- which results in a phenomenon termed? which is corrected by? -Burn pts are at risk for.... if one of the following conditions are present? this should be started if not contraindicated?

complications of the emergent phase-respiratory -what are the two injuries that the respiratory system is vulnerable to in burns? -what may the pt need to confirm a suspected inhalation injury? -look in the prehospital and ED notes to see? -what is a common complication of major burns? -If fluid replacement is too vigorous watch for early signs of?

complications of the emergent phase-urinary system -what is the most common complication of the urinary sys in the emergent phase of burns? -if your pt becomes hypovolemic...... causing? if this continues what may develop

clinical manifestations of tuberculosis -symptoms of pulmonary TB usually do not develop until...? the primary manifestations is an...? -active tb disease may initially present with.... such as? what is a late symptom that may signify considerable pulmonary disease or a pleural effusion? this symptom also occurs in less than 10% of pts with tb, and is also a late symptom? -sometimes TB has a more acute sudden presentation such as a? -the symptoms of extrapulmonary TB depend on the?

complications of tuberculosis -properly treated pulmonary tuberculosis typically heals without complications except for? -miliary tb is widespread dissemination of the? the bacterium spreads throughout the.... to? the infection is characterized by a large amount of.. and may be? manifestations slowly progress over a period of? what is present? what also may occur? -pleural tb a specific type of extrapulmonary tb can result from either? what are the common side effects? what is used to confirm the diagnosis?

complications of PE -about 10% of pts with PE? treatment with...significantly reduces mortality? -complications include? -pulmonary infarction (death of lung tissue) is most likely when there is.... occlusion of a large or medium sized...? insufficient collateral blood flow from the? or preexisting? infarction results in? sometimes the necrotic tissue become... and a.... may develope? -pulmonary hypertension results from...or from? as a single event a pe rarely causes pulmonary hypertension.

diagnostic studies of PE -is a laboratory test that measures the amount of cross linked fibrin fragments? -is the most common test to diagnose PE? an injection of IV.... is needed to view the pulmonary vessels? if the pt cannot have this what type of scan is done? -what is important but not diagnostic of PE? can show low?

what are the classifications of asthma? complications of asthma -depending on the pts response asthma can rapidly progress from normal breathing to? -status ashtmaticus- a....? it is characterized by? the pt must be immediately....? what is essential and critical for the pt? what might be given for the pt with with a very low FEV or peak flow?

diagnostic studies of asthma -what may be used to determine if a person has had similar attacks which are often precipitated by a know trigger? -what may be used to test lung function? these can help predict an? test results depend on the persons? -what is usually normal between asthma attacks if the pt has no other underlying pulmonary disease? when this is scheduled the pt must stop taking any? for how long? this can be done before or after the administration of... to determine the degree of the response? -what is highly suggestive of atopy? what may be used to determine sensitivity to specific allergens? however? -this is usually normal in an asymptomatic pt? this is usually not done unless?

antihistamines drug therapy -oral antihistamines are helpful in treating? may have what kind of effect....? antihistamines such as.....bind to peripheral histamine receptors without giving a sedative effect?

diagnostics and surgical therapy -skin scraping- scraping with a scalpel blade....? the most common test of skin scraping...? -curettage- is the removal...? looks like a? although? the area to be curetted? -punch biopsy-a common procedure used to obtain...? -cyrosurgery-is the use of?

interprofessional care of PE -to reduce the risk of mortality? -goals are to provide...prevent....prevent...and prevent?

drug therapy for PE -what is required for pts with PE? -subcutaneous administration of... is recommended treatment for pts with acute PE? this is safer than? -what can be used in severe cases?

emergent phase -the emergent (resuscitative) phase is? the phase usually last up to? the main concerns of the emergent phase are? the emergent phase ends when? -patho map- at the time of the burn there is? all the fluids of the blood begin to... causing? what increases causing the blood to become more viscous? the combination of decreased blood volume and increased viscosity produces? what can rapidly ensue and if not corrected can result in death? pathophysiology of the emergent phase of burns -the greatest initial threat to a pt with a major burn is? it is caused by a major shift of....bc of..... and can begin as early as? as the capillary walls become more permeable.... move into the....? The colloidal osmotic pressure... this results in? -the normal insensible loss of 30 to 50 ml/hr is higher in severly burned pts in which they can lose up to? the net result of fluid shifts and losses is termed? -signs of hypovolemic shock include? -the circulatory system is affected by? thrombosis in the capillaries of burned tissue cause? A high hematocrit is often caused by? after fluid balance is restored the? -what major electrolyte shifts occur during the emergent phase? the shift of what occurs because? sodium rapidly moves into the interstitial spaces and...? -toward the end of the emergent phase....? interstitial fluid....? diuresis occurs and the urine?

emergent phase-inflammation and healing -burn injury to tissues and vessels cause? so what accumulates at the site of the injury? what appears and they begin wound repair within the first? emergent phase- immunologic challenges -what barrier to invading organisms is destroyed in burn injuries? what occurs and decreases? what occurs in WBC's?

scabies etiology and patho -mite penetrates the... and? -allergic reactions are to? -transmission is by? -rarely seen in? clinical manifestations -severe.... especially at? usually not on? -presence of? -erythematous..? treatment and prognosis -%5....? -treat all? -treat? -abx if? -possible residual pruritis...? -recurrence possible?

fungal infections- candidias etiology and patho -caused by? aka? -50% of adults are? -appears in? -immunosuppression from? allow? clinical manifestations mouth? vagina? and skin? treatment and prognosis -Azole...? -sexual? -skin? -powder?

bacterial infections -can occur as what? -when an infection is present, the resulting drainage is? -what are necessary to prevent the spread of infection? -what are the major types of bacteria responsible for primary or secondary infections?

impetigo etiology and patho -Group A B-hemolytic....? -associated with..? -primary or secondary......? clinical manifestations -vesiculopustular lesions...? -most common on? treatment and prognosis -topical?-wound care with...followed by... and application -systemic?

herpes zoster (shingles) etiology and patho -activation of? -incidence increased with? -potentially? clinical manifestation -linear distribution....? -usually..? -burning....? -mild to...? treatments and prognosis -topical? -systemic?-antiviral agents within?, at bedtime? whats used to treat post therpetic nueralgia? usually? vaccine?

infestations and insects bites -what are infestations? what plays a key role in the reaction? what are the common infestations and insect bites?

interprofessional care drug therapy-abx what are some common OTC topical abx? HCP's do not recommend?-bc? prescription topical abx include? what is the drug of choice for severe infections?

interprofessional care drug therapy- corticosteroids -How can corticosteroids be used? what kind of effects do these drugs have? what is the most potent delivery system for a topical corticosteriods? Intralesional corticosteroids are injected right into the? systemic corticosteroids can caused what?

types of pneumothorax -typically occurs due to the rupture of small blebs (air-filled sacs) on the surface of the lung. these blebs can occur in.... or from lung disease such as? what increases the risk for bleb formation? -occurs when air enters the pleural space but can't escape? may result from a? is a medical? effects both the.... systems? manifestations include? -is the accumulation of blood in the pleural space from injury to the chest wall, diaphragm, lung, blood vessels, or mediastinum. -is the presence of lymphatic fluid in the pleural space? the thoracic duct is disrupted either.... allowing? the milky white fluid is high in? may be treated with? -can occur due to laceration or puncture of the lung due to a medical procedure?

interprofessional care for a pneumothorax -treatment of a pneumothorax depends on its? -emergency treatment consists of covering the wound with? -the most definitive and common treatment of a pneumothorax and hemothorax is to.... and connect it to? -tension pneumothorax is a medical emergency that requires... followed by? -if the object that caused an open chest wound is still in place....? stabilize the impaled object with a? wait until a... or?

diagnostic studies of tuberculosis -what is the standard method to screen people for M. tuberculosis? the test is read by inspection and palpation in.... for? induration a palpable, raised, hardened area or swelling at the injection site means the person has? an induration of 5 mm or larger means the test is? -although chest x rays are important it is not....? the chest x ray may appear? findings suggestive of TB include? other diseases such as.... can mimic tb on a chest x ray. -bacteriologic studies- what is the gold standard for the diagnosis of TB? how many consecutive sputum specimens are need? each are collected at... intervals, with at least? the initial test involves a microscopic examination of stained sputum smears for?

interprofessional care for tuberculosis -this may be needed for the severely ill or debilitated? -active tb disease- it is important to manage the pt with active tb? drug therapy is divided into 2 phases which are? In most circumstances the treatment for pts with previously untreated tb consists of a..... which includes? if drug susceptibility test results show that the bacteria are susceptible to all drugs what may be stopped? -latent tuberculosis infection- in people with LTBI drug therapy helps prevent...? usually only....? the standard treatment regimen for LTBI is.....? while the 9 month regimen is more effective adherence issues make the? -directly observed therapy- involves providing the antitubercular drugs directly to the pt and....? to..... it is the preferred strategy for all pts with tb. drug alert for isonazid -avoid...? and monitor for signs of... during treatment

interproffesional care-radiation what conditions are radiation therapy used for? who are the best candidates for radiation therapy? use is limited in those with? requires multiple? Can produce? other adverse effects include? what is needed to prevent ocular lens damage if the irradiated area is around the eye?

interprofessional care-laser technology -lasers can make? they can? laser light does not? with less damage to the surrounding tissue?

lipoma etiology and patho -benign tumor of? -most common in which age group? clinical manifestations -rubbery...? -single or? -variable...? -most common on? treatment and prognosis -usually? -biopsy to? -excision?

lentigo etiology and patho -increased number...? -aka? clinical manifestations -hyperpigmented...? treatment and manifestations -evaluate..? -treatments for cosmetic purposes? -may? -biopsy when suspicous of?

acute care for pts with TB -those strongly suggested to have TB should...?

lung cancer -smoking causes? -the risk for developing lung cancer is directly related to total? -other common causes of lung cancer include high levels of?

diagnostic studies of lung cancer -is the first diagnostic test done for pts with suspected lung cancer? -is used to further evaluate the lung mass? -can identify cancer cells but these are rarely used in diagnosing lung cancer because cancer cells are not always present in this? -a definitive diagnosis requires a? -what may be used to obtain cells for biopsy -what may be used to evaluate and stage lung cancer?

lung cancer interprofessional care -this is the treatment of choice in NSCLC stage 1-3a without mediastinal involvement? - surgical procedures include? -when the tumor is considered operable, the pts.... must be evaluated to determine the ability to have surgery? -radiation therapy may be given as? -radiation may be used as... for the pt who is unable to tolerate...? -what may be used in the treatment of lung cancer for nonresectable tumors or as adjuvant therapy to surgery?

squamous cell carcinoma what is it? can be... and has the potential to? may lead to...? what factors may contribute to the formation of SCC on the mouth and lips? etiology and patho -frequent occurence...? -malignant tumor of..? clinical manifestation -most common on? -superficial? -early? -late? Treatment and prognosis -surgical...? -untreated lesions may? -what is given for noninvasive SCC? -what is given for metastatic lesions? -high cure rate with...?

melonoma -what is it? 100% curable if diagnosed at stage? etiology and patho -neoplastic growth of? -classification? -potential? clinical manifestation -irregular... -variegated... -flat.... -often? -most common sites? treatment and prognosis -surgical... -adjuvant therapy... -correlation between.. -poor prognosis unless.... -spreading by....

interprofessional care of asthma drug therapy -asthma drugs are divided into 2 general types which are? -corticosteriods- must be used for... before maximum therapuetic effects can be seen? must be used on a? what are local side effects that are caused by inhalation of corticosteriods? these problems can be reduced by? -leukotriene modifiers- these drugs interfere with the synthesis or block? they are only used for? -SABA are the most effective drugs for relieving? aka? these drugs have an onset within...and last up to? too frequent use of SABA indicates? the use of SABA drugs should be limited to? -LABA including...are effective for? when LABA are added to a pts daily regimen of corticosteroids they? LABA's should never be used? they should only be used if? tell pts that these drugs should not be used to? teach the pt that these drugs are only to be used every? -anticholinergics promote? they are more effective in treating pts with? anticholinergic drugs are not used in the routine management of asthma except for in?

nursing management -teach the pt to identify and avoid? -washing bedclothes in....has some effects on allergen levels? -when cold air cannot be avoided dressing properly with...reduces the risk for an asthma attack? -what drugs are contraindicated because they inhibit bronchodialation? -prompt diagnoses and treatment of...may prevent an asthma attack? -if exercise is planned or if the pt has asthma only with exercise, the HCP can suggest?

acute phase complications- nuerologic system -the pt probably wont have any physical symptoms unless. -the pt may become extremely? delirium is more acute at.... and occurs more often in? start appropriate nursing interventions to prevent?

nursing management in the acute phase- wound care -what may be used for enzymatic debridement of burn wounds in which they...? -cleanse wounds with what to gently remove the old antimicrobial agent and any loose necrotic tissue, scabs, or dried blood? -during the debridement phase, cover the wound with? -if grafting is done, protect the skin graft with the same... followed by? -with facial grafts, the unmeshed sheet graft is left open, so it is possible for? these prevent the graft from? the evacuation of the bleb is best done by? and only those?

nursing management in the acute phase- physical and occupational therapy -a good time for excercise is? -passive and active ROM? -maintain the OT schedule for wearing custom fitted splints, which are designed to?

nursing management in the acute phase-nutritional therapy -Monitor laboratory values such as? -ideally weight loss should not be more than? -record the pts daily caloric intake using? -weigh your pt... to evaluate progress?

nursing management in the emergent phase- airway management -airway management of involves? Early.... removes the need for? In general the pt with facial and neck burns needs to be...... within...? -after intubation the pt is placed on.... with settings based on? what may be done to relieve respiratory distress with circumferential full-thickness burns to the chest and neck? -what should be done to assess the lower airway within..... after the injury if smoke inhalation is suspected. -when intubation is not done treatment of inhalation injury includes? place the pt in a? Encourage? reposition pt every? Provide see the safety alert on pg 440

nursing management in the emergent phase- fluid therapy -what must be placed for pts with burns that are 15% TBSA or more? what is critical? -for pts with burns that are 30%TBSA or more consider a? -A.... is placed if the pt needs frequent? -fluid replacement is achieved with? what is usually started during the prehospital phase? -what is the most common formula for fluid replacement? -Colloid solutions may be given however...? bc -assess for the adequacy of fluid resuscitation hourly using which clinical parameters? what do the parameters state?

nursing management in the emergent phase-drug therapy -in the early postburn period, what kind of pain medicine should be given because? -what is the drug of choice for severe pain? -consider what kind of approach to pain control? what drugs can be given with analgesics to control anixety, insomnia, or depression that pts may have.? -all burn pts routinely recieve.... because of the risk anaerobic burn wound contamination? if the pt has not received an active immunization within 10 years before the burn....? -systemic antibiotics are only used if? oral infection is treated with? when a normal diet is resumed what may be reintroduced to normal intestinal flora that was destroyed by antibiotic therapy? -for vte, if there are no contraindications, it is recommended that...... be started as soon as it is considerably safe. For pts who have a high bleeding risk vte prophylaxis with...?

nursing management in the emergent phase-nutrition therapy -once fluid replacement needs have been addressed, what takes priority in the initial emergent phase. -Early and aggressive nutritional support within several hours of the burn injury can decrease...? -non intubated pts with a burn of less the 20% of TBSA will? -intubated pts and those with larger burns? Early enteral feeding usually with smaller bore tube....? In general, begin the feedings slowly at a rate of.... and increase to the goal rate within? If a large ng tube is used...? assess bowel sounds every? -A hypermetabolic state proportional to the..... occurs after a major burn injury. resting metabolic expenditure may be increased by? Core temperature is? what else is increased? Massive catabolism can occur and is characterized by? what may be given in the emergent phase?

nursing management in the emergent phase-wound care -once... has been achieved priority is given to? -partial-thickness burn wounds appear? these wounds may or may not have? -you can perform cleansing and gently debridement using..... on a? extensive surgical debridement is done in the? -what is part of the routine in many burn centers? -infection can cause? the source of infection in burn is likely? -two approaches to burn wound treatment are? in the open method? In the multiple dressing change or closed method? -use sterile gloves when applying?

nursing management in the emergent phases-other therapies -instill... into the eyes for moisture and comfort? -extend burned hands and arms... to reduce edema. -assess the need for? remove when it is no longer needed to limit the risk for? -if your pt has frequent, loose stools, consider?

nursing management of the acute phase- excision and grafting -what is an example of a skin replacement system? it is used in the treatment of ? it must be applied within? -the integra artificial skin has a bilayer membrane composed of? the wound is...the bilayer membrane is placed..... and the wound is wrapped with? the dermal layer functions as a? the silicone layer stays intact for...., and epidermal autografts...? at this point the silicone is.... and replaced by? -another dermal replacement...? human allograft dermis, harvested from... is..?

nursing management of the acute phase- pain management -burn pts usually have 2 kinds of pain? -with back ground pain frequent..... provides? if tolerating food? -anoxiolytics and adjuvant analgesics can? the use of these drugs can help? -breakthrough doses of analgesia must be? -for treatment induced pain?

Nursing management-topical medications -common bases for topical medications 23.12- creams, gels, lotion, ointment, powder, and paste

nursing management-control of puritis -what kind of environment? what is normally helpful? apply...?

bed bugs etiology and patho -what species? -feeding is...? usually at? -present in? clinical manifestations -wheal...? -firm...? -severe? -often grouped in? treatment and prognosis -lesions usually require? -severe itching may require?

pendiculosis (lice) etiology and patho -obligate parasites that... clinical manifestations -minute....? -points flush with...? progression to? -itching -secondary excoriation....? -nits and eggs are...? treatment and prognosis -used to treat various parts of the body? -used to treat scalp and hair? -screen and treat...? -do not share?

acute bronchitis -is a self limiting...? what is the most common symptom that may last up to....is the most common reason to seek? -is often present? although some pts have? the presence of what color sputum is not a reliable indicator of? other symptoms include? -diagnoses is based on the? assessment may reveal normal....usually on... and with? consolidation which occurs when...suggestive of.... is what with bronchitis? Chest x rays are?- and are.... unless? -goal of treatment is to? treatment is? it includes? what may help relieve the cough? what is useful for pts with wheezes or underlying pulmonary conditions? these may be given to pts with underlying chronic conditions who have a prolonged infection associated with systemic symptoms? abx are not given for viral infections because they have? -encourage pts to not? avoid? and to what often? -if a pt with acute bronchitis is due to influenza virus treatment with what may be started? -if a pt with acute bronchitis develops a fever, has difficulty breathing, or has symptoms lasting longer than 4 weeks they should?

pertussis -is a highly...caused by? -manifestations of pertussis occur in? the first stage lasting... manifest as a...? the second stage from the.... is characterized by? the last stage last...and is characterized by a? -the hallmark characteristic of pertussis is a? inspiration after each cough produces a... as the pt tries to breath in air.....? -unlike bronchitis the cough with pertussis may last from? -the treatment of pertussis is with... such as...to? for the pt who can not take these abx what is the treatment? -the pt with pertussis is infectious from the beginning of....or until? -pts should not use.... as they are ineffective and may induce coughing episodes. -what is also not helpful? -the CDC recommends?

pleural effusion thoracentesis -is the aspiration of.... for? -the pt may sit...and? -what are used to determine the optimal puncture site? -the skin is cleansed with a.... and? the thoracentesis needle is inserted into the? fluid is aspirated with....or? -usually no more than..... of fluid is removed at one time? rapid removal of large volume can result in? -during and after the procedure, monitor....and? observe the pt for?

pleural effusion treatment -the management of a pleural effusion involves treating?

pathophysiology of pneumonia -almost all pathogens trigger a? -inflammation characterized by... activates...? as a result, the inflammatory process attracts more......? normal o2 transport is affected leading to? -atelectasis, the.....may occur with pneumonia? it rarely causes any adverse effects except? On the other hand......occurs when the normally air filled alveoli becomes filled with water, fluid, and or debirs?

pneumonia clinical manifestations -the most common presenting symptoms of pnuemonia are? the cough may be? Sputum may be? Viral pneumonia may be seen as.... with respiratory symptoms appearing and/or worsening.... after onset? -the older or debilitated pt may not have? what may be the only finding? what also may be seen in the older adult? Nonspecific manifestations may include? -on assessment....? if consolidation is present? pts with a pleural effusion may have?

pneumonia complications -atelectasis- occurs when? can be relieved with? -pleurisy-inflammation of the? -pleural effusion- is when...enters the pleural space? in most cases the effusion is.... and reabsorbed in? sometimes effusions require? -bacteremia- bacterial infection in? is more likely to occur in infections with? -pneumothorax- occurs when.... collects in the pleural space causing? -acute respiratory failure- failure occurs when pneumonia damages the....? -sepsis/septic shock- can occur when..... enter the bloodstream? severe sepsis can lead to?

pneumonia diagnostic studies -what often gives enough information to make immediate decisions about early treatment? -chest x ray often shows..... and is important in diagnosing pneumonia. x ray may also show? . -what may be used to obtain fluid samples from pts not responding to initial therapy? -arterial blood gases may be obtained to assess for? -Luekocytosis usually occurs in pts with? the wbc is usually greater than... with presence of? -ideally what is obtained before beginning antibiotic therapy? however? what is done for pts who are seriously ill?

nursing management of lung cancer -the best way to halt the epidemic of lung cancer is to prevent people from? -because most smokers start in the.... prevention of... has the most significant role in reducing the risk of lung cancer?

pneumothorax -is caused by? normally... exist between the visceral pleura and the parietal pleura? when air enters this space the change to.... causes...? -a pneumothorax should be suspected after any? -on auscultation, breath sounds are.... over the affected area?

chest surgery- video assisted thoracic surgery -is? -provides....image of the inside of the chest cavity? -what is placed through 1 or more of the incisions at the end of the procedure? secured with? connected to? -advantages of VATS includes?

post op care for chest surgery -pain after a thoracotomy is typically... bc...? -the use of...allows pts to breathe deeply, cough, and move the are and shoulder on the operative side? -nursing care priorities the post operative period include assessment of?

Pre hospital and emergent care -what is priority at the scene of the injury? -in cases of electrical or chemical injuries, initial care involves? -small thermal burns (10% or less of TBSA) should be covered with a? cooling of the area if small within....? -if the burn is large (greater than 10% of TBSA) or an electrical or inhalation burn is suspected, and the pt is unresponsive.....? -if the pt is responsive your priorities would follow the order of? -to prevent hypothermia cool large burns....? Do not? Never cover a burn in ice since?

pre hospital and emergent care -chemical burns are best treated? remove all... because? -flush the affected area with....? what is acceptable for flushing the eyes exposed to chemicals? -tissue damage may continue for up to.... for some chemicals? -watch pts with inhalation injuries closely for? If the pt has suspected CO poisoning, treat the pt with? -pts with both burn and inhalation injury must be?

what are the benign conditions of the skin?

psoriasis etiology and patho -autoimmune chronic....? -family? -usually developes before age? clinical manifestations -sharply? -itching? -localized or general? -symptoms vary in? treatments and prognosis -goal of treatment? -topical treatments? -systemic treatments?

rehabilitative phase -the formal rehabilitative phase begins when the pts? -burn wounds heal by? the new skin appears? in about.... the area becomes? -If adequate ROM is not started, the new tissue will.... causing? -mature healing is reached in about.... when? -scarring has two characteristics? the discoloration of scars.... however? gentle pressure is maintained on the healed burn with? pressure garments should never be worn over? once a wearing schedule has been set? -the pt usually reports... where healing is occurring? teach your pt about the application of? what may also help? -the newly formed skin is extremely sensitive to.... what afe likely to develop from slight pressure or friction? these newly healed areas can be hypersensitve or hyposensitive to?

rehabilitative phase-complications the most common complication in the rehabilitative phase are? areas that are most susceptible to these are?

the cornerstone of skin examination is the? examine the skin lesions for?

skin cancer -what are the 7 risk factors for skin cancer? -what can help you determine a pts skin complexion and how likely is it that they will get skin cancer? -table 23.3 -pts treated with...?

who should be especially cautious about sun exposure and why? when teaching pts ways to avoid the damaging effects of the sun what does this include? when is the greatest risk of sun exposure? how much percent of UV rays occur at this time? even occurs on?

sun screens -Products labled "broad spectrum block? Sunscreens with broad spectrum labeling must have? Sunscreens with a SPF of 15 or more... -The general recommendation is that everyone should use? teach pts to look for the term? Those who have a history of skin cancer or problems with sun sensitivity? Sunscreens should be applied?

tuberculosis -is an infectious disease caused by? it usually involves? TB is the leading cause of mortality in pts with? etiology and patho -M. tuberculosis is a gram...? it usually spreads from person to person by? the pt will need what kind of room? -tb is not highly.... as transmission usually requires?

tuberculosis classification -occurs when the bacteria are inhaled and start an inflammatory reaction. Most people mount effective..... to encapsulate these organisms for...? if initial immune response is not adequate, the body cannot.... as a result the bacteria..... and what results? -is defined as TB disease occurring two or more years after the initial infection? if the site of TB is pulmonary or laryngeal, the person is....? -occurs in a person who does not have active TB disease. people with this have a positive... but are? They cannot transmit the TB bacteria to others but can...?

Burns what is a burn? Most burns are? what are the common sources of burns in table 24.1? (home hazards (3), general household (9), and occupational hazards (9))

types of burn injury thermal burns- caused by? the severity of the injury depends on the? scald injuries often occur? flash, flame, or contact burns can occur while? -chemical burns- are the result of contact with? In addition to skin damage...? acids are found in..... and include? Alkali burns can be more difficult to.....and they are found in? Organic compounds including...produce? -smoke and inhalation injury- caused from and can damage? what are the 3 smoke and inhalation injuries that can occur? they are a major predictor of? Rapid initial....? what can quickly develop within hours of injury? -electrical burns- results from? what can occur? the severity of the electrical injury depends on the? what may help reveal the likely path of the current and potential areas of injury? contact with electrical current can cause? another reason to suspect long bone or spinal injury....? For this reason... continue? electrical injury puts the pt at risk for? the electrical shock can cause immediate? what can occur within the first 24 hours without warning? whenever massive muscle and blood cell damage occurs...this can lead too?

pneumonia -is a acute infection of the lung? etiology -normally, various defense mechanisms protect the airway...? mechanisms that create a mechanical barrier to microorganisms entering the tracheobronchial tree include? immune defense mechanisms include? -pneumonia is more likely to occur when defense mechanisms become...? -pathogens that cause pneumonia reach the lungs in 3 ways which are?

types of pneumonia -is an acute infection of the lung occurring in pts who have not been hospitalized or lived in a long-term care facility within 14 days of the onset of symptoms? -aka nosocomial pneumonia, is a pneumonia in a non intubated pt that begins 48 hours or longer after admission to the hospital and was not present at the time of admission. -a type of HAP, refers to the pneumonia that occurs more than 48 hours after endotracheal intubation? -results from the abnormal entry of material from the mouth or stomach into the trachea and lungs? conditions that increase this risk are? Assessing pneumonia severity -what may be used as a supplement to clinical judgement to determine the severity of pneumonia and if pts need to be hospitalized? pts receive one point for each of the following indicators which are? a score of 0-2 indicates? a score of 3-4 indicates? and a score of 5-8 indicates?

classification of burns-pt risk factors -what pt conditions have a poorer prognosis of recovery.... because of? -pts with... are at a high risk for delayed wound healing especially with foot or leg burns. -General physical weakness from any... make it challenging for the pt to fully recover from a burn injury. -what other conditions a burn pt might have that may place them for difficult recovery?

what are the phases of burn management? -what is the primary focus of the acute phase, but takes place in both the emergent and rehabilitative phases? -Planning for rehabilitation begins....? Formal rehabilitation begins as soon as?