Med-Surg HESI Flashcards

cardiac function
Terms Definitions
emphysema:
barrel chest
difficulty exhaling
strongly associated with smoking
"pink puffer"
persistant tachycardia bc of inadequate O2
hyperinflated lungs and flattened diaphragm
increase fluid intake = liquify secretions
immunization against pneumonia q5 years
Urine Specific Gravity:
1.003-1.030
Creatinine:
K+:
Na+:
Creatinine: 0.2-1.0
K+: 3.5-5
Na+: 135-145
What causes Cushing's syndrome?
corticosteroids
What is normal HgbA1C?
4-6
ABG Values:
pH
PaCO2
PaO2
pH: 7.35-7.45 high--alkalosis
PaCO2: 35-45 high-- acidosis
Pa02: 75-100
what is osteomalacia in children?
Rickets
What is a digoxin level?
0.8-2.0
What test is for MG?
tensilon
peripheral arterial disease:
patient experiances intermittent claudication
pain is relieved when extremity is in DEPENDANT position
What is the range for Hct?
35-45%
What is neupogen?
colony-stimulating factor for neutrophils
What is PCP?
opportunistic infection pneumocystic carini/jirovecii pneumonia
What does parathyroid control?
Ca & P
what test measures bone density?
DEXA scan
What is the range for Hgb?
12-16
What is the range for plt?
150,000-450,000
TB
acid fast bacillus (acid fast sputum test)
infection results from frequent close contact with infected person
immunity = granuloma lesion
part of this lesion = Ghon focus and material from here = passage of infectious particles to more airways WHERE THEY CAN BE EXHALED
characteristic frothy pink sputum
early symptom: nonproductive early morning cough
keep patient in private room with negative pressure
HCP wears N95 mask, patient wears normal face mask
INH for 12 months = drug of choice w/abnormal chest x ray or immunocompramized (HIV)
what causes Cushing's disease?
excess produciton of cartisol
When in Alzheimer's is reorientation ineffective?
Stage 2-3
When dealing with Alzheimer's what is the best tactic?
diversion
What is the range for RBC?
4.5-6.0 million
How many mls are in a teaspoon?
5
How many mls are in an oz?
30
how is PAC treated?
reduce alcohol, caffeine intake
reduce stress
stop smoking
what is compartment syndrome?
impaired circulation caused by external pressure>30 mmHg (normal 10-20) that results in tissue death and nerve injury.
What are the SE of biological response modifiers treated with?
Tylenol
What is of main concern with hyperthyroidism?
cardiac function
What is acromegly?
excess secretion of GH after puberty
What are the S&S of hypoglycemia?
cold, clammy, dyphoresis
What are the side effects of colony-stimulating factors?
flu-like symptoms
what are the manifestations of compartment syndrome?
unrelieved, relentless pain, diminished or absent pulses distal to the injury, cyanosis of the extremity, parasthesia, loss of sensation, pallor, coolness, and weakness
CALL MD FOR BIVALVE ASAP!
what is an adverse effect of long term aminoglycoside use?
nephrotoxicity
What is myxedema coma?
extension of hypothyroid S&S that results in a coma
What does fatigue do with Alzheimer's
increases confusion
(should promote sleep at all stages)
What are S&S of hypercalcemia?
apathy, depression, muscle weakness, EKG changes, fatigue anorexia, n/v
What drug is used to treat MS?
methyleprednisone and corticosteroids
How does metformin work?
decreases sugar production in the liver and helps the muscles use insulin to break down sugar
What do you treat the side effects of colony-stimulating factors with?
Tylenol
how is sinus tachycardia treated?
treated only when patient is symptomatic or at risk for mycardial damage
treat underlying cause (hypovolemia, fever, pain etc)
beta blockers or verapamil may be used
Band Neutrophils normal 0-8%
increased in:
acute infection-- shift to the left
What lab values would be alarming for a cancer pt?
leukocytosis, neutropenia, thrombocytopenia, anemia
What needs to be done to detect what type of CVA?
CT scan
what is medication therapy for osteoporosis?
-estrogen replacement therapy in post menapausal women is a PREVENTATIVE measure (pill or skin patch)
-calcitonin; hormone secreted by thyroid gland- it increases bone density
-aledronate prevents bone resorbtion; for men and women with steroid induced osteoporosis
-Evista; selective receptor modulator that prevents bone loss
how do beta blockers reduce BP?
decreasing CO response to sympathetic nerve stimulation and renin secretion by the kidneys
reduces sympathetic vascular resisitance
used in
-HTN
-MI
-Arrhythmias

***avoid in patients with COPD
when is RLS the worst?
When the pt is trying to rest
what kind of drugs are used to treat gout?
anti-inflammatory agents like colchicines, NSAIDs, or corticosteroids
antihyperuricemics like alopurinol
and uricosurics like probenecid (increase exxcretion through urine)
what role does the SNS have in cardiac function?
produces epinephrine and norepinephrine = increasing HR, myocardial contractility, and peripheral vasocontriction resulting in raised BP
(FLIGHT/FIGHT)
What are the S&S of diabetes insipidus?
What is it treated with?
high urine output, low specific gravity
DDAVP or desmopresin
What are the SE of cryptosporidiosis and what is it?
disease caused by an intestinal parasite. Watery diarrhea and often abdominal cramping
what the difference in S&S between acromegly and giantism?
Acromegly: hads, fee, and face big
Giantism: everything's big
What is the onset and peak of intermediate acting insulin?
Onset: 1-2 hours
Peak: 4-8 hours
What are the levels of T3, T4, and TSH in hypothyroid?
T3/T4 down
TSH up
what are important assessments for the nurse to make post laminectomy?
CMS checks and bowel and bladder function
complaints of severe headache, N/V, abdominal discomfort = CSF leak or CSF infection
some numbness and tingling is NORMAL and may persist for a little while
what part of the CNS controls cardiac function?
ANS: regulates cardiac function and BP
balance between sympathetic and parasympathetic branches
what is the importance of increased plasma uric acid?
diagnostic for gout; its the end product in metabolism of purines, and the kidneys normally secret it.
hyperuricemia occurs with poor kidney function, and or excessive purine intake
What test are done to confirm ALL?
CBC, bone marrow aspiration, and bone marrow biopsy
what is important to teach a patient with THR?
avoid adduction, and 90 degree flexion of the effected hip
-avoid sitting cross legged
-avoid twisting to reach for objects
-avoid tub baths for 4-6 weeks
- raise toilet seats and use sock pullers etc to avoid hyperflexion
-**physical therapy starts the next day post op!
what role does the PSNS have in cardiac function?
produces acetocholine = lowered HR and decreased contractility, opposite of sympathetic stimulation
What should be known about the bifosfinates?
take on empty stomach, take with a full glass of water, sit up for 30-60 min after taking
how can a nurse facilitate plaster cast drying?
turn the patient from side to side q2h for the first 24 to 72 hours
DONT use fingertips to turn, only palms- finger tips can create indentations in cast
things to remember about care of a patient with a chest tube:
-keep it below the level of the chest = gravity
-occlusive dressing around tube
-NEVER milk the tube unless ordered*
-NEVER clamp chest tube
-monitor output hourly
What do you do with a pt that is neutropenic with a fever?
medical emergency, call MD, that pt is priority
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