Med-Surg Final

Normal ejection fraction

50 to 65, below 35 is bad

Arterial Insufficiency

Absent pulse, dependent rubor, minimal edema, ulcers on the heals or toes, dry shiny skin, cool to the touch, intermittent claudication

Which of the following is the only curative treatment for chronic myeloid leukemia (CML)?

Allogeneic stem cell transplant Allogeneic stem cell transplantation remains the only curative treatment for CML. The efficacy of Imatinib as first-line treatment and the treatment-related mortality of stem cell transplant limits use of transplant to patients with high risk or relapsed disease, or in those patients who did not respond to therapy with TKI. Cytarabine and idarubicin are part of induction therapy for acute myeloid leukemia (AML).

Mitral Valve Prolapse

Cause unknown; possibly hereditary. No prophylactic antibiotics--> in their life they will become immune. May develop vegetation (endocarditis).

Pericarditis

Classic symptpom: chest pain, may have hiccups (and not responding to thorazine) get an EKG. They have a pericardial friction rub louder on exhalation

A-Fib is at risk for

Clots; prescribe antibiotics

Cardiomyopathy

Fluid overload from too much sodium causes HF

Aortic Valve Regurgitation

High pitched; at the 3rd and 4th left sternal border (like mitral valve stenosis--may develop from rheumatic endocarditis). Give them ACEI or CCB--asmptomatic at first, when symptoms finally develop you die

Inffective Endocarditis

Immunocompromised, prosthetic heart valve, older age, IV drug users

What does digoxin do?

It helps the heart beat stronger with more force; helps with A-Fib

What is S3 heart sound associated with

Left ventricular heart failure

Aortic Valve Stenosis

Low pitched crescendo and decresendo, vibrating, S4, report weight gain (3lbs in one day, 5 lbs ina week).

Mitral Valve Stenosis

Low pitched rumbling diastolic murmur at the apex, starts at 1/3 of size, prevent rheumatic fever, avoid being a jock or pregnant (no strenuous activity).

Myocarditis need to know

Monitor for digoxin levels since there susceptible, .5 to 2 ng

Which type of pneumonia has the highest incidence in clients with AIDS and clients receiving immunosuppressive therapy for cancer?

Pneumocystis pneumonia incidence is greatest in clients with AIDS and clients receiving immunosuppressive therapy for cancer, organ transplanation, and other disorders.

A patient with polycythemia vera is complaining of severe itching. What triggers does the nurse know can cause this distressing symptom? (Select all that apply.)

Pruritus is very common, occurring in up to 70% of patients with polycythemia vera (Saini, Patnaik & Tefferi, 2010) and is one of the most distressing symptoms of this disease. It is triggered by contact with temperature change, alcohol consumption, or, more typically, exposure to water of any temperature but seems to be worse with exposure to hot water.

Venous Insufficiency

Pulse is pressent but diminished, skin is reddish blue, severe edema, tough, thickened skin, on tibia or lateral malleolus, irregular border, tends to superficial minimal pain

A patient comes to the clinic with fever, cough, and chest discomfort. The nurse auscultates crackles in the left lower base of the lung and suspects that the patient may have pneumonia. What does the nurse know is the most common organism that causes community-acquired pneumonia?

Streptococcus pneumoniae (pneumococcus) is the most common cause of community-acquired pneumonia in people younger than 60 years without comorbidity and in those 60 years and older with comorbidity (Wunderink & Niederman, 2012). S. pneumoniae, a gram-positive organism that resides naturally in the upper respiratory tract, colonizes the upper respiratory tract and can cause disseminated invasive infections, pneumonia and other lower respiratory tract infections, and upper respiratory tract infections such as otitis media and rhinosinusitis. It may occur as a lobar or bronchopneumonic form in patients of any age and may follow a recent respiratory illness.

Which statement best describes the function of stem cells in the bone marrow?

They create all blood cells

If a patient has any ventricular dysrhythmia what do you give them

Ventricular amioderone

Which nursing intervention is most appropriate for a client with multiple myeloma?

When caring for a client with multiple myeloma, the nurse should focus on relieving pain, preventing bone injury and infection, and maintaining hydration. Monitoring respiratory status and balancing rest and activity are appropriate interventions for any client. To prevent such complications as pyelonephritis and renal calculi, the nurse should keep the client well hydrated — not restrict his fluid intake.

Induction therapy

is the first phase of treatment for multiple myeloma. The goal of induction therapy for multiple myeloma is to reduce the number of plasma cells (myeloma cells) in the bone marrow and the proteins that the plasma cells produce.

Hf sodium

restrict 2 grams or less, take

S/S of infective endocardidtis

splinter hemmorhages, petechiae, oslers nodes, jane way lesions,

Cardiac output

stroke volume x Heart rate